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Test Name:
Tobramycin, Peak Level
- SBMF No:
29190 - Performance Lab Name:
Automated Lab - Test Mnemonic:
POST TOBRA - ABN:
Not required - CPT Code:
80200 - LOINC Code:
4057-6 - Also Known As:
Aminoglycoside
Nebcin - Also See:
29180 Tobramycin, Trough Level
31010 Tobramycin, Random or Non-Specified Level - Spec Type:
Serum - Spec Container:
Red top (serum) tube - Alt Spec Type:
Plasma - Alt Spec Container:
Green top (lithium heparin) tube - Pref Vol:
1.0 mL - Min Vol:
0.3 mL - Fasting:
No - Patient Prep:
Administer IV infusions over 60 minutes time period
Document exact start and end times of infusions, or exact times of injections, on requisition - Spec Collect:
Do not use gel-barrier tubes for specimen collection
Routine venipuncture
Suggest that drug be dosed using pharmacokinetic procedures
Recommended "peak" level collection times:
– IV Infusion: 30 minutes after end of 1 hour infusion
– IM Injection: 60 minutes after time of injection
Note: Collect "trough" level immediately prior to start of infusion or just prior to injection - Spec Process:
Clot 30 minutes
Promptly centrifuge 15 minutes
Within 60 minutes of collection, transfer serum or plasma to separate plastic tube
Refrigerate and transport refrigerated
If Tobramycin is co-administered with β-lactam antibiotics (penicillins and cephalosporins), freeze serum (-20°C) and transport frozen - Spec Store Transport:
Refrigerated - Spec Stability:
1 week refrigerated (2-8°C)
1 month frozen (-20°C) – Do not use frost-free units that undergo repeated freeze/thaw cycles - Methodology:
Enzyme Immunoassay (EIA) - Use:
Used in the diagnosis and treatment of tobramycin overdose and in monitoring levels of tobramycin to ensure appropriate therapy - Clinical Significance:
Tobramycin is an aminoglycoside antibiotic used in the treatment of infections caused by Pseudomonas aeruginosa, Proteus species, E. coli, Klebsiella, Serratia, Citrobacter, Staphylococcus aureus, Enterobacter and other bacilli. Tobramycin's toxic effect is produced by interfering with ribosomal protein synthesis. Tobramycin undergoes very little, if any, metabolization and is, therefore, eliminates the parent drug by glomerular filtration. The half-life of tobramycin in serum or plasma correlates closely with renal function and thus is quite variable between individuals and within one individual over times. Serum or plasma tobramycin concentration is also impacted by mode of administration, the volume of extracellular fluid, the duration of the treatment and physiological changes during the illness and therapy.The therapeutic range of tobramycin should be measured at peak as well as trough concentrations. In patients with pre-existing renal damage or those to whom tobramycin has been administered for prolonged periods or in doses above the therapeutic range, hearing impairment and/or nephrotoxicity may develop. Therefore, monitoring of peak and trough tobramycin serum or plasma levels is critical in the prevention of these serious complications with the adjustment of dosage administration as indicated. - Reference Range:
Peak: 4-10 µg/mL
Trough: 1-2 µg/mL - Critical High Value:
Peak: >12 µg/mL
Trough: >2 µg/mL - Day Run:
Sun-Sat (daily) - Time Run:
As received - Time Reported:
4 hours - Test Type:
TOX-TDM
