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24961 Amikacin, Random, Serum (RAMIK)

Amikacin, Random, Serum (RAMIK)
Test Code: RAMIKSO
Synonyms/Keywords

​Amikacin Sulfate (Amikin); Amikacin, Random, S; Amikin (Amikacin Sulfate); Antibiotic Assay; Antimicrobial Assay; Amikacin, Random, Serum; RAMIKASO

Useful For
​Monitoring adequacy of blood concentration during amikacin therapy.
Specimen Requirements
 
 
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT)0.5 mL​​0.25 mL ​
Collection Processing Instructions
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
Additional Information: Serum for a peak level should be drawn 30 to 60 minutes after last dose (order PAMIK / Amikacin, Peak, Serum). Serum for a trough level should be drawn immediately before next scheduled dose (order TAMIK / Amikacin, Trough, Serum).
Specimen Stability Information
Specimen Type Temperature Time
​Serum​ Refrigerate (preferred) 14 days
Frozen ​28 days
​Ambient ​72 hours
Rejection Criteria

Gross Hemolysis

Interference

​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.

Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Clinic Laboratories​ Monday through Sunday 1 day​
Kinetic Interaction of Microparticles in Solution (KIMS)
Reference Lab
Mayo Clinic Laboratories
Test 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 Range Information
Performing Location Reference Range
Mayo Clinic Laboratories​

Peak: 20.0-35.0 mcg/mL

Toxic peak: >40.0 mcg/mL

Trough: <8.0 mcg/mL

Toxic trough:>10.0 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, for prolonged periods of time, peak serum concentrations are maintained >35.0 mcg/mL, or trough concentrations are maintained at >10.0 mcg/mL.

Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​80150 ​ ​ ​ ​
Synonyms/Keywords

​Amikacin Sulfate (Amikin); Amikacin, Random, S; Amikin (Amikacin Sulfate); Antibiotic Assay; Antimicrobial Assay; Amikacin, Random, Serum; RAMIKASO

Ordering Applications
Ordering Application Description
COM Amikacin, Random, Serum (RAMIK)
​Cerner ​Amikacin, Random, S (RAMIK)
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
 
 
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
Serum​ Serum Separator Tube (SST) ​Red Top Tube (RTT)0.5 mL​​0.25 mL ​
Collection Processing
1. Serum gel tubes should be centrifuged within 2 hours of collection.
2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.
Additional Information: Serum for a peak level should be drawn 30 to 60 minutes after last dose (order PAMIK / Amikacin, Peak, Serum). Serum for a trough level should be drawn immediately before next scheduled dose (order TAMIK / Amikacin, Trough, Serum).
Specimen Stability Information
Specimen Type Temperature Time
​Serum​ Refrigerate (preferred) 14 days
Frozen ​28 days
​Ambient ​72 hours
Rejection Criteria

Gross Hemolysis

Interference

​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.

Useful For
​Monitoring adequacy of blood concentration during amikacin therapy.
Reference Range Information
Performing Location Reference Range
Mayo Clinic Laboratories​

Peak: 20.0-35.0 mcg/mL

Toxic peak: >40.0 mcg/mL

Trough: <8.0 mcg/mL

Toxic trough:>10.0 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, for prolonged periods of time, peak serum concentrations are maintained >35.0 mcg/mL, or trough concentrations are maintained at >10.0 mcg/mL.

For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
Mayo Clinic Laboratories​ Monday through Sunday 1 day​
Kinetic Interaction of Microparticles in Solution (KIMS)
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​80150 ​ ​ ​ ​
For most current information refer to the Marshfield Laboratory online reference manual.