Type: Q

Test 1088

SuperUser Account — Tue, 16 Sep 2008 22:05:50 GMT

Test: Quinidine, Serum
Number: 007831
CPT: 80194
Synonyms: Cardioquin® ; Duraquin® ; Quinaglute® ; Quinidex® ; Quinora®
Specimen: Serum or plasma
Volume: 1 mL
Minimum Volume: 0.3 mL
Container: Red-top tube or green-top (heparin) tube
Collection: Transfer separated serum or plasma to a plastic transport tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.

Peak: quinidine sulfate: 11/2 hours after dose, quinidine gluconate: 4 hours after dose; trough: immediately prior to next dose; after change in dose: 1-2 days

Storage Instructions: Refrigerate
Causes for Rejection: Gel-barrier tube; severe hemolysis; lipemia; icteric specimen
Reference Interval: Therapeutic: 2.0-5.0 μg/mL
Use: This Class 1A drug is useful in both supraventricular and ventricular arrhythmias. It major uses are to maintain sinus rhythm after conversion of atrial flutter or fibrillation, to prevent ventricular tachycardia, and for long-term prophylaxis in patients with AV nodal reentrant tachycardia and automatic atrial tachycardia. Quinidine also has been used to prevent symptomatic premature supraventricular and ventricular complexes. Because it slows conduction and prolongs the refractory period of the accessory pathway and suppresses automaticity of ectopic pacemakers, quinidine may prevent recurrences of paroxysmal supraventricular tachycardia caused by reentry over a concealed pathway or AV reciprocating tachycardia associated with the Wolff-Parkinson-White syndrome. It also may slow the ventricular response to atrial flutter or fibrillation in the pre-excitation syndrome. Quinidine is often preferred to procainamide for long-term therapy because elevated antinuclear antibody titers and drug-induced lupus are common during prolonged therapy with procainamide.
Methodology: Immunoassay
Additional Information: Optimal resampling time after change in dosage is 1-2 days. Biologic half-life is about 6-8 hours. Doses of quinidine >250 mg/day result in increased serum digoxin concentrations about 2.5 times the digoxin concentration before quinidine was added. The new steady-state of digoxin concentration occurs in 7-14 days, with signs of toxicity beginning to appear in 3-7 days after initiation of quinidine therapy. Therefore, serum digoxin concentrations should be measured before initiation of quinidine therapy and again in 4-6 days. Measure trough because of variability of peak interval. Renal failure prolongs apparent half-life, perhaps through accumulation of fluorescent metabolites. Severe heart failure also prolongs half-life, as does liver disease. Concomitant administration of phenytoin increases hepatic metabolism, and therefore decreases half-life and serum quinidine concentrations. Clearance may be diminished in the elderly.¹
Footnotes: 1. Montamat SC, Cusack BJ, Vestal RE. ?Management of Drug Therapy in the Elderly,? N Engl J Med. 1989; 321(5):303-309.
References: ????AMA, Division of Drugs and Toxicology, Drug Evaluations Subscription, Chicago, IL: American Medical Association, Winter 1993.

Test 1491

SuperUser Account — Tue, 16 Sep 2008 22:25:08 GMT

Test: Q Fever Antibodies, IgG
Number: 016774
CPT: 86638
Synonyms: Coxiella burnetii Antibodies
Test Includes: Titer of both Phase I and Phase II responses
Specimen: Serum
Volume: 0.4 mL
Minimum Volume: 0.2 mL
Container: Red-top tube or gel-barrier tube
Storage Instructions: Maintain specimen at room temperature.
Causes for Rejection: Hemolysis; lipemia; gross bacterial contamination
Reference Interval: Negative: <1:16
Use: Aid in the differential diagnosis for Q fever
Methodology: Indirect fluorescent antibody (IFA)

Test 2989

SuperUser Account — Wed, 17 Sep 2008 00:02:24 GMT

Test: Quantitation of BK Virus DNA using Real Time PCR (Urine)
Number: 138880
CPT: 87799
Synonyms: Polyomavirus BK Quantitation
Specimen: Urine
Volume: 5 mL
Minimum Volume: 2 mL
Container: Sterile urine container without preservatives
Collection: Urine-any type
Storage Instructions: Refrigerated
Stability: Refrigerated up to 7 days
Use: Detects and quantitates BK virus DNA in urine specimens.
Methodology: Real time DNA amplification and detection
References: ?????Whiley DM, Mackay IM, Sloots TP. Detection and differentiation of human polymaviruses JC and BK by Light Cycler PCR. J Clin Microbiol 2001; 39:4357-4367.

Test 2993

SuperUser Account — Wed, 17 Sep 2008 00:02:45 GMT

Test: Quantitation of BK Virus DNA using Real-time PCR
Number: 138962
CPT: 87799
Synonyms: Polyomavirus BK Quantitation
Specimen: Whole blood, serum or plasma
Volume: 5 mL whole blood or 1 mL serum or plasma
Minimum Volume: 2 mL whole blood or 0.5 mL serum or plasma
Container: Lavender-top (EDTA) tube, yellow-top (ACD) tube, plasma preparation tube (PPT), or gel-barrier tube
Collection: Serum or plasma must be separated from cells within 45 - 60 minutes of veinpuncture. Send serum or plasma in a plastic transport tube.
Storage Instructions: Maintain specimen at room temperature.
Stability:
Whole blood: Room temperature up to 7 days
Serum or plasma:
Room temperature up to 7 days
Refrigerated up to 7 days
Causes for Rejection: Insufficient volume; leaking or broken tube; inadequate storage and transport.
Use: Detect and quantitates BK virus DNA in clinical specimens.
Methodology: Real-time DNA amplification and detection
References:

????Whiley, DM, Mackay IM, Sloots TP. Detection and differentiation of human polymaviruses JC and BK by Light Cycler PCR. J. Clin Microbiol. 2001; 39:4357-4367.