Tricyclic antidepressants—blood level measurements and clinical outcome. Diuretics that act on the proximal tubule can affect lithium clearance. Toxic reactions to lithium and neuroleptics. In addition, trisbutoxyethylphosphate, once a component of blood-collection tube stoppers, had been shown to decrease measured concentrations of TCAs.
Development of the Kodak Ektachem clinical chemistry slide for lithium Li Abstract. Chronic renal failure has little or no effect on disposition of parent compounds and demethylated metabolites. Description Tricyclic antidepressants act to change the balance of naturally occurring chemicals in the brain that regulate the transmission of nerve impulses between cells.
How to Prepare for the Test. Administer lower dose and titrate at a slower rate. The laboratory personnel should contact the hospital unit to report critical values for inpatients and should contact the treating physician for critical outpatient values. Ereshefsky LJann MW. Clinical Chemistry May44 5.
To adjust for a return to prepregnancy renal elimination of lithium, Shafey has suggested that therapy should be discontinued several days before the anticipated delivery date and then resumed several days postpartum at the prepregnancy dose Amitriptyline disposition in young and elderly normal men.
This increase was not seen in patients aged over age 24 years; a slight decrease in suicidal thinking was seen in adults over age 65 years. Although the interference of this compound from the stoppers has been eliminated, analysts should be cautious when exposing specimens to materials that have not been evaluated for their effects on measured TCA concentrations. For example, in geriatric patients, decreased metabolic capacity of the liver, decreased hepatic blood flow, and possible changes in the volume of distribution 60 can all contribute to increased TCA blood concentrations under standard dosing conditions.
Consequently, after the introduction of an enzyme-inducing agent, TCAs should be monitored for about twice the time expected to achieve the maximal induction effect to ensure stabilization of steady-state concentrations.
Because of the potential for dire consequences of overdose, TCA and lithium concentrations after an overdose should be reported as soon as possible. Tackley RMTregaskis B.
Tricyclic antidepressant sample stability and the Vacutainer effect. Applied clinical pharmacokinetics The American Psychiatric Association task force on the use of laboratory tests in psychiatry recommends that the method chosen for TDM of TCAs be specific and capable of measuring the antidepressant drug itself as well as any active metabolites without interference from other metabolites or drugs that may be administered concurrently.
Prior Authorization Drugs that require prior authorization. Emit assays for doxepin, bupropion, and clomipramine are not available. Nortriptyline is a tricyclic antidepressant used for treatment of endogenous depression. Initially, blood collected into heparin-containing tubes was preferred because more plasma than serum could be obtained from the same volume of blood. By clicking send, you acknowledge that you have permission to email the recipient with this information.