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Dec 11, 2017

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Clinical Hub,Tools & Resources,UWHC Lab Test Directory,Toxicology

Digoxin

Digoxin (DIG) Toxicology Lab Test

Name: Digoxin

Test Name: Digoxin

Health Link Test Code: DIG

LIS Test Code: DIGO

CPT Code(s): 80162

Methodology: Particle Enhanced Turbidometric Inhibition Immunoassay (PETINIA)

Clinical Information:

Cardiotonic

Days Performed: Daily, 24 hours.

In-Lab Turnaround Time: 4 hours.

Stat In-Lab Turnaround Time: 1 hour.

Specimen: Blood

Collection Container: Red top

Also Acceptable: Green top

Collection Instructions:

Collection of specimen must be at least 6 hours after an IV dose or at least 8 hours after a PO dose.

Collection Volume: 2 mL

Pediatric Collection Volume: 0.4 mL

Stability Refridgerated:

48 hours

Stability Frozen:

7 days

Sample Analyzed: Serum

Testing Volume: 1 mL

Pediatric Testing Volume: 0.2 mL

Specimen Processing:

Centrifuge. Transfer cell-free serum or plasma to plastic vial. Refrigerate.

Specimen Transport:

Transport specimen to the laboratory. Transport with coolant pack if coming from clinic location.

Unacceptable Criteria:

Specimens collected in red cap with yellow ring (SST) or green cap with yellow ring (PST) tubes are not acceptable.

Interpretation:

Generally effective therapeutic concentration: 0.5-0.9 ng/mL

Test Limitations:

Administration of Digibind makes Digoxin levels invalid until Digibind (digoxin immune fab) has been cleared from the patient's system, approximately six weeks.

Endogenous, digoxin-like immunoreactive factors (DLIF) have been detected in the serum and plasma of neonates, pregnant women, and patients in renal and hepatic failure.  Several studies have established that these factors can cause falsely elevated digoxin measurements when assayed by commercially available immunoassays.

Critical Calls: yes

Additional Information:

Result of "BELOW" indicates that the result is below the method detection limit of 0.2 ng/mL. Patient response to the drug varies. Potassium depletion increases sensitivity to the drug. Renal dysfunction decreases elimination of digoxin, causing an accumulation of the drug in the serum. Half-life is 32-48 hours depending on patient's renal function and can be 100 hours in anephric patients.