Test Code PAMIK Amikacin, Peak, Serum
Useful For
Monitoring adequacy of serum concentration during amikacin therapy
Method Name
Kinetic Interaction of Microparticles in Solution (KIMS)
Reporting Name
Amikacin, Peak, SSpecimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red top tubes should be centrifuged, and the serum aliquoted into a plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | |
Frozen | 28 days | ||
Ambient | 72 hours |
Reject Due To
Gross hemolysis | Reject |
Clinical Information
Amikacin is an aminoglycoside used to treat severe blood infections by susceptible strains of gram-negative bacteria. Aminoglycosides induce bacterial death by irreversibly binding bacterial ribosomes to inhibit protein synthesis. Amikacin is minimally absorbed from the gastrointestinal tract, and thus can been used orally to reduce intestinal flora.
Peak serum concentrations are seen 30 minutes after intravenous infusion, or 60 minutes after intramuscular administration. Serum half-lives in patients with normal renal function are generally 2 to 3 hours. Excretion of aminoglycosides is principally renal, and all aminoglycosides may accumulate in the kidney at 50 to 100 times the serum concentration.
Toxicity can present as dizziness, vertigo, or, if severe, ataxia and a Meniere disease-like syndrome. Auditory toxicity may be manifested by simple tinnitus or any degree of hearing loss, which may be temporary or permanent, and can extend to total irreversible deafness. Nephrotoxicity is most frequently manifested by transient proteinuria or azotemia, which may occasionally be severe. Aminoglycosides also are associated with variable degrees of neuromuscular blockade leading to apnea.
Reference Values
Peak: 20.0-35.0 mcg/mL
Toxic peak: >40.0 mcg/mL
Interpretation
For conventional (nonpulse) dosing protocols, clinical effects may not be achieved if the peak serum concentration is <20.0 mcg/mL. Toxicity may occur if the peak serum concentration is maintained >35.0 mcg/mL for a prolonged period of time.
Cautions
Aminoglycosides are excreted primarily by glomerular filtration, thus, the serum half-life will be prolonged and significant accumulation will occur in patients with impaired renal function.
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 dayPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
PAMIK | Amikacin, Peak, S | 3319-1 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
PAMIK | Amikacin, Peak, S | 3319-1 |
CPT Code Information
80150
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.