Drug Monitoring

Amikacin is an aminoglycoside antibiotic used in the treatment of gram-negative bacillary infections. Amikacin is potentially nephrotoxic and ototoxic and serial monitoring of peak and trough serum levels provides information to maintain safe and therapeutic levels.

Amikacin is an aminoglycoside antibiotic used in the treatment of gram-negative bacillary infections. Amikacin is potentially nephrotoxic and ototoxic and serial monitoring of serum levels provides information to maintain safe and therapeutic levels.

Amikacin is an aminoglycoside antibiotic used in the treatment of gram-negative bacillary infections. Amikacin is potentially nephrotoxic and ototoxic and serial monitoring of serum levels provides information to maintain safe and therapeutic levels.

Amikacin is an aminoglycoside antibiotic used in the treatment of gram-negative bacillary infections. Amikacin is potentially nephrotoxic and ototoxic and serial monitoring of serum levels provides information to maintain safe and therapeutic levels.

Amiodarone is an antiarrythmic drug. Therapeutic drug monitoring is useful to monitor compliance and avoid toxicity.

AMPHETAMINE, QUANTITATIVE LC/MS/MS, SERUM

 

Clinical Significance

This test is useful to monitor prescribed drug therapy. It is also utilized as a confirmation test for positive screen results that automatically reflex for confirmation at an additional charge.

Amphetamines, Quantitative, LC/MS/MS, Serum

Clinical Significance

This test is useful to monitor prescribed drug therapy. It is also utilized as a confirmation test for positive screen results that automatically reflex for confirmation at an additional charge.

Rapidly growing mycobacteria and Nocardia/aerobic Actinomycetes can cause a variety of serious infections, particularly in immunocompromised patients. Resistance, toxicity, intolerance, and therapeutic failures may occur with traditional empiric treatment with drugs of choice. Antimicrobial susceptibility testing, especially with newer agents, may help to guide appropriate therapeutic choices.

Clinical Significance

Aripiprazole (Abilify®) is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression. The analysis of aripiprazole is used to monitor compliance with drug therapy.

Description: Cancer antigen 125 is present in most ovarian cancer cells. This test is used to measure the amount of CA 125 in the blood. It can be used to monitor treatment, assess patients who have successfully treated cancer, or check if there may be ovarian cancer present.

Also Known As:  CA 125 Tumor Marker, Cancer Antigen 125 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation is required

Average Processing Time: 2 to 3 days

When is a CA 125 test ordered?

The CA-125 test may be administered before a woman begins treatment for ovarian cancer to serve as a baseline against which future values can be compared. A healthcare practitioner may order CA-125 testing at intervals during therapy to check the response to treatment. After therapy is finished, CA-125 can be evaluated on a regular basis.

When a woman develops a pelvic mass, a healthcare practitioner may conduct a CA-125 test to determine what's causing it.

When a woman is at high risk of developing ovarian cancer, certain healthcare practitioners may prescribe a CA-125 test and an ultrasound at regular intervals.

What does a CA 125 blood test check for?

Cancer Antigen 125 is a protein found on the surface of most ovarian cancer cells, but not all. In certain instances, this makes the test useful as a tumor marker. The CA-125 test determines how much CA-125 is present in the blood.

CA-125 concentrations in the blood of an ovarian cancer patient may be significantly increased. As a result, the test could be used to track the success of treatment and/or check for cancer recurrence. However, because not all women with ovarian cancer have increased CA-125, the test may not be appropriate in all circumstances.

Ovarian cancer is the fifth leading cause of death among women. According to the American Cancer Society, a woman's lifetime risk of acquiring ovarian cancer is roughly 1 in 75, with a 1 in 100 chance of dying from it. According to the American Cancer Society, around 22,000 new cases are identified each year in the United States, with approximately 14,000 women dying as a result.

Only around 20% of ovarian tumors are discovered in the early stages before they have progressed beyond the ovary. The signs of ovarian cancer are extremely non-specific, which is one of the main reasons they go unnoticed.

Ongoing research is being driven by the need for a dependable tool for the early identification of ovarian cancer in asymptomatic women. In the meanwhile, it's critical to get frequent physicals and pelvic exams and be aware of your family's medical history and symptoms.

Because CA-125 is non-specific, it is not suggested as a screening test for asymptomatic women. CA-125 is produced in small amounts by normal tissues throughout the body, as well as by some malignancies. A range of non-cancerous diseases, such as menstruation, pregnancy, and pelvic inflammatory disease, can cause somewhat high levels in the blood.

Lab tests often ordered with a CA 125 test:

• CEA
• BRCA Gene Mutation

Conditions where a CA 125 test is recommended:

• Ovarian Cancer

How does my health care provider use a CA 125 test?

Cancer Antigen 125 is a tumor marker that is primarily used to track therapy during ovarian cancer treatment. CA-125 is also used to see if cancer has returned after therapy has ended. CA-125 tests with rising or falling concentrations are generally more informative than a single result.

CA-125 is sometimes used in conjunction with transvaginal ultrasonography to screen and monitor women who are at high risk for ovarian cancer but have not yet been diagnosed with the disease. An inherited genetic mutation in one of two genes, breast cancer gene 1 or breast cancer gene 2, is the most significant risk factor for ovarian cancer. Family history, advancing age, reproductive history and infertility, hormone replacement treatment use, and obesity are all risk factors.

To explore a mass in a woman's lower abdomen area, a CA-125 test may be ordered in conjunction with a transvaginal ultrasound.

However, because the test is non-specific, it is not used to screen women for ovarian cancer. The US Preventive Services Task Force advises against ovarian cancer screening in women. This advice is for asymptomatic women only; it does not apply to women who are at a high risk of developing ovarian cancer, such as those who have a genetic mutation.

There is currently no single reliable approach for detecting ovarian cancer in asymptomatic women. Only around 20% of ovarian tumors are discovered in their early stages, before they have progressed beyond the ovary. The signs of ovarian cancer are extremely non-specific, which is one reason they go unnoticed. In the meanwhile, it's critical to get frequent physicals, pelvic checks, and be aware of family history and other risk factors.

What do my CA 125 test results mean?

If CA-125 levels drop throughout treatment, it usually means that the malignancy is responding to it. If CA-125 levels increase or remain unchanged, the cancer may not be responding to treatment. CA-125 values that are elevated after therapy may suggest that the cancer has returned.

If a woman has been diagnosed with ovarian cancer and has a normal baseline CA-125 level, the test is unlikely to be beneficial in monitoring her illness. CA-125 is not a suitable predictor of disease development in this scenario because the ovarian cancer may not be making it.

A considerably raised CA-125 is concerning in a woman with a pelvic mass or in a woman who has a high risk of developing ovarian cancer, but it does not always imply ovarian cancer. This discovery would lead to more testing and evaluation.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

CA 125 is used as an aid in monitoring the response to therapy for patients with epithelian ovarian cancer and in detecting residual ovarian cancer in patients who have undergone therapy. HAMA pre-treatment inhibits possible heterophilic interference.

Description: The cancer antigen 15-3 test is used to measure the levels of the cancer antigen 15-3 that is present with breast cancer. This test is commonly used to monitor and watch for recurrence of breast cancer.

Also Known As: Cancer Antigen 15-3 Test, CA-Breast Test, Cancer Antigen-Breast Test, CA153 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a CA 15-3 test ordered?

When advanced breast cancer is first detected, CA 15-3 may be administered together with other tests to assist evaluate cancer features and treatment options. If CA 15-3 is initially raised, it may be ordered on a regular basis to assess therapy effectiveness and to help detect recurrence. When breast cancer is identified early, before it has progressed, CA 15-3 is usually not ordered since levels are not raised in the majority of early tumors.

What does a CA 15-3 blood test check for?

Normal breast cells produce cancer antigen 15-3, which is a protein. The production of CA 15-3 and the related cancer antigen 27.29 is enhanced in many persons with malignant breast tumors. CA 15-3 does not induce cancer; instead, tumor cells dump it into the bloodstream. CA 15-3 is measured in the blood in this test.

CA 15-3 is a tumor marker that may be tested in the blood and used to track the progression of cancer. CA 15-3 is high in fewer than half of women with early-stage breast cancer or a small tumor, whereas it is elevated in nearly 80% of women with advanced breast cancer. The test isn't always useful because not all women with invasive breast cancer have increased CA 15-3.

Because it is non-specific, CA 15-3 is not recommended as a screening test for breast cancer in women. It can also be increased in healthy persons and people who have tumors of the colon, lungs, pancreatic, ovary, or prostate, as well as certain illnesses like cirrhosis, hepatitis, and benign breast disease.

Lab tests often ordered with a CA 15-3 test:

• CEA
• HER2/neu test
• Estrogen Receptor Status
• Progesterone Receptor Status
• Gene Expression tests

Conditions where a CA 15-3 test is recommended:

• Breast Cancer

How does my health care provider use a 15-3 test?

The cancer antigen 15-3 test, as well as the associated CA 27.29 test, are primarily used to track therapy response and detect breast cancer recurrence. They are used in conjunction with other clinical evaluations and tests to assess a person's breast cancer, such as estrogen and progesterone receptors, Her2/neu, and genomic testing for breast cancer.

CA 15-3 is occasionally ordered to get a sense of how much cancer is present. Because CA 15-3 can only be used as a marker if the cancer produces high levels of it, this test isn't appropriate for everyone with breast cancer.

Because non-cancerous diseases can induce increased levels, the CA 15-3 and CA 27.29 tests are not precise or specific enough to be used as cancer screening tests.

What do my CA 15-3 test results mean?

The greater the CA 15-3 level, the further advanced the breast cancer is and the more cancer is found in general. CA 15-3 levels tend to rise as the cancer progresses. When metastatic breast cancer has progressed to the bones and/or liver, the highest levels of CA 15-3 are frequently detected.

CA 15-3 levels that rise over time may suggest that a patient is not responding to treatment or that the cancer has returned.

Normal CA 15-3 levels do not rule out the possibility of metastatic or localized breast cancer. It could be too early in the disease process to identify elevated CA 15-3 levels, or the person could be one of the roughly 20% to 25% of advanced breast cancer patients whose tumors do not shed CA 15-3.

CA 15-3 levels are mild to moderate in a number of illnesses, including lung, pancreas, ovary, prostate, and colon cancer, as well as cirrhosis, hepatitis, and benign breast abnormalities, and in a small percentage of seemingly healthy people. CA 15-3 levels in non-cancerous circumstances are generally constant over time.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: The cancer antigen 19-9 test screens for a protein that exists on the surface of certain cancer cells. The CA 19-9 test can be used to measure the level of these proteins in the blood and is useful as a tumor marker.

Also Known As: Carbohydrate Antigen (CA) 19-9 Test, Cancer Antigen 19-9 Test, Cancer Antigen (CA) 19-9, Carbohydrate Antigen 19-9 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 2 to 3 days

When is a CA 19-9 test ordered?

When a person has been diagnosed with pancreatic cancer or has signs and symptoms that could indicate pancreatic cancer, CA 19-9 may be ordered. Early warning signs and symptoms can be vague and ambiguous.

If CA 19-9 levels are initially increased in pancreatic cancer, a series of CA 19-9 tests may be conducted to assess response during therapy and on a frequent basis after treatment to assist detect recurrence.

When a healthcare practitioner suspects bile duct cancer in a person with a bile duct obstruction, CA 19-9 may be prescribed. CA 19-9 levels can spike due to non-cancerous reasons of bile duct obstruction, but they drop once the blockage is addressed. In these circumstances, re-checking CA 19-9 levels should be done at least a week or two after the blockage has been cleared.

What does a CA 19-9 blood test check for?

The protein cancer antigen 19-9 is found on the surface of some cancer cells. CA 19-9 does not cause cancer; rather, it is emitted by tumor cells and can be discovered in blood and other bodily fluids by laboratory tests. The level of CA19-9 is measured in this test.

Because CA 19-9 can be tested in the blood, it can be used as a tumor marker to track the progression of cancer. CA 19-9 levels are high in 70% to 95% of persons with advanced pancreatic cancer.

CA 19-9 levels may also be elevated in cancers of the gallbladder and bile ducts, colorectal cancer, gastric cancers, ovarian cancer, lung cancer, liver cancer, pancreatitis, thyroid disease, and liver disease, among other cancers, conditions, and diseases. CA 19-9 is found in trace levels in the blood of healthy humans. CA 19-9 cannot be utilized for screening or diagnosis by itself because it is not specific for pancreatic cancer.

Lab tests often ordered with a CA 19-9 test:

• Bilirubin
• Carcinoembryonic Antigen
• Hepatic Function Panel
• Tumor Markers

Conditions where a CA 19-9 test is recommended:

• Pancreatic Cancer
• Pancreatitis
• Colorectal Cancer
• Gastric Cancers
• Lung Cancer
• Ovarian Cancer
• Cystic Fibrosis
• Liver Cancer
• Thyroid Disease
• Liver Disease

How does my health care provider use a CA 19-9 test?

The CA 19-9 test, along with other tests like carcinoembryonic antigen, bilirubin, and/or a liver panel, can be used to evaluate and monitor someone who has been diagnosed with pancreatic cancer and is having treatment.

CA 19-9 can only be utilized as a tumor marker if it is produced in large amounts by the malignancy. CA 19-9 may be ordered to help evaluate and monitor persons with bile duct cancer because it is high in roughly 65 percent of those with this type of cancer.

The CA 19-9 test is insufficiently sensitive and specific to be used as a cancer screening test. Because non-cancerous diseases can induce elevated CA 19-9 levels, it is not yet effective for detection or diagnosis. Researchers are still looking at markers that can be used alone or in combination with CA 19-9 to help diagnose and screen for pancreatic cancer in its early stages, when it is most curable.

What do my CA 19-9 test results mean?

Healthy persons have low levels of CA 19-9, although numerous illnesses that affect the liver or pancreas can induce transitory spikes.

People with pancreatic cancer, other malignancies, and a variety of other diseases and ailments may have moderate to high levels. CA 19-9 levels are higher in cancers of the exocrine pancreas. This cancer develops in the tissues that manufacture food-digesting enzymes, as well as in the ducts that transport those enzymes to the small intestine. This kind of pancreatic cancer accounts for approximately 95% of all pancreatic cancers.

CA 19-9 levels that rise and then diminish over time may indicate that the treatment is functioning and/or that the malignancy was successfully removed during surgery. Levels that stay high or rise over time could suggest that treatment isn't working and/or that the cancer is reoccurring.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

CA 27.29 may be useful for monitoring patients for metastatic breast cancer.

Coffee, tea and other beverages may contain caffeine. Caffeine is a methylxanthine found in over the counter products and in prescription medications. Small premature infants with mild respiratory distress shortly after birth may be treated with theophylline or caffeine. In neonates, a significant amount of theophylline is converted to caffeine. Since the demethylation pathway of theophylline is relatively undeveloped, caffeine levels may be elevated. Caffeine clearance rates typically reach adult values at about 3-4 months of age.

Description: CEA is a test that measures the levels of carcinoembryonic antigens in the blood. It is used to evaluate a person who has been diagnosed with cancer. The levels of CEA maybe elevated with certain types of cancer.

Also Known As: Carcinoembryonic antigen Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a CEA test ordered?

When a person is diagnosed with colon cancer or another type of cancer, a CEA test may be ordered. It will be evaluated before treatment begins and subsequently on a frequent basis to assess treatment success and detect recurrence.

When cancer is suspected but not yet diagnosed, a CEA test may be conducted. Although CEA can be increased with a variety of illnesses, this is not a popular usage for the test, it may provide additional information to a healthcare practitioner.

When a healthcare practitioner suspects that a cancer has metastasized, a CEA test may be conducted on a fluid other than blood.

What does a CEA blood test check for?

Carcinoembryonic antigen is a protein found in the developing tissues of a fetus. It drops to a very low level by the time a baby is delivered. CEA is generally seen in extremely low amounts in the blood of people, but it can be raised in cancer patients. This test examines the quantity of CEA in the blood to aid in the evaluation of cancer patients.

CEA is a tumor indicator. CEA was once assumed to be a particular marker for colon cancer, however subsequent research has revealed that an elevation in CEA can be detected in a variety of malignancies. Non-cancer disorders such as inflammation, cirrhosis, peptic ulcer, ulcerative colitis, rectal polyps, emphysema, and benign breast disease, as well as smokers, can cause an increase in CEA. As a result, it is ineffective as a general cancer screening tool, although it does play a role in assessing cancer therapy response. An initial CEA baseline test may be performed after a person has been diagnosed with cancer. If this level is raised, serial CEA testing may be used to track the cancer's progress as the patient receives treatment.

Lab tests often ordered with a CEA test:

• Tumor Markers
• CSF Analysis
• Body Fluid Analysis
• CA 19-9
• Calcitonin
• Alpha Fetoprotein
• Antiphospholipid Antibodies

Conditions where a CEA test is recommended:

• Colon Cancer
• Colorectal Cancer
• Pancreatic Cancer
• Ovarian Cancer
• Breast Cancer
• Thyroid Cancer
• Lung Cancer

How does my health care provider use a CEA test?

The carcinoembryonic antigen test can be utilized in the following situations:

• To keep track of the treatment of persons who have been diagnosed with colon cancer. It can also be used as a marker for rectum, lung, breast, liver, pancreatic, stomach, and ovary malignancies. Prior to therapy, a CEA test is usually ordered as a "baseline" measurement. If the level is high, the test can be used to track a patient's response to treatment and see if the cancer has advanced or returned.
• Cancer staging entails determining the size of the tumor as well as the extent to which it has spread.
• CEA testing in a bodily fluid sample can help doctors figure out if cancer has progressed to a body cavity like the chest or abdomen.
• In the examination of cancer, a CEA test can be performed in conjunction with other tumor markers.

CEA is not produced by all malignancies, therefore a positive CEA test does not always indicate cancer.

What do my CEA test results mean?

Monitoring treatment and recurrence: CEA levels that are first raised but later return to normal following treatment indicate that the cancer has been successfully treated. The first symptom of tumor recurrence is frequently a progressively rising CEA level.

Staging: People with smaller and early-stage tumors are more likely to have a normal or slightly raised CEA score on initial testing. A high CEA value is more probable in people with larger tumors, later-stage cancer, or cancers that have disseminated throughout the body.

Testing for metastasis: If CEA is found in a bodily fluid other than blood, the cancer has most likely migrated to that part of the body. If CEA is found in CSF fluid, for example, it could suggest that cancer has spread to the central nervous system.

Because not all malignancies produce CEA, it's possible to have cancer and a normal CEA at the same time. The test will be useless as a surveillance tool if a malignancy does not produce CEA.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

CEA is a tumor marker that is useful to monitor patients with persistent, recurrent or metastatic colonic carcinoma. Patients who have received mouse monoclonal antibodies as part of treatment should have their specimens pre-treated for removal of the human antimouse antibodies (HAMA).

Cyclosporine (Cyclosporin A) is an immunosuppressant therapeutic agent used in the prevention of organ graft rejection. Clinical measurement of blood levels is required due to the inter-individual variability of metabolism as well as the toxicity associated with excessive dosage.

Cyclosporine (Cyclosporin A) is an immunosuppressant therapeutic agent used in the prevention of organ graft rejection. Measurement of blood levels is recommended due to the inter-individual variability of metabolism as well as the toxicity associated with excessive dosage.

Cyclosporine is a commonly used immunosuppressive drug in patients receiving transplants. LC/MS/MS methods have higher specificity for the parent compound than immunoassay. Therapeutic drug monitoring is useful to optimize dose and avoid toxicity. High cyclosporine levels can lead to nephrotoxicity; Low levels can lead to organ rejection following transplant. Peak concentrations are reached at around 3.5 hours after oral dosage. Elimination half-life is 10-27 hours.

Dexamethasone

 

Clinical Significance

Test used in the differential diagnosis of Cushing's syndrome.

Digoxin is a cardiac glycoside derived from the digitalis plant. It is used to treat congestive heart failure and atrial dysrhythmias. Digoxin levels are monitored to assure adequate therapeutic levels are achieved and to avoid toxicity.

Disopyramide is useful in treating patients with cardiac arrhythmias and tachcardia. Therapeutic drug monitoring is useful to optimize dose and avoid toxicity.

Recently, inhibitors of anaplastic lymphoma kinase (ALK) have been used successfully in treating patients harboring gene fusions between echinoderm microtubule-associated protein-like 4 (EML4) and ALK. This is a reverse transcription PCR-based exon scanning approach to encompass fusion variants spanning nearly the entire EML4 gene.

Misleading medical information will be conveyed if extended-spectrum beta-lactamase producers are resported as sensitive when they are actually resistant. Strains of K. pneumoniae and E. coli and a few other genera of the family enterobacteriaceae that produce ESBLs may clinically be resistant to therapy with penicillins, cephalosporins, or aztreonam, despite apparent in vitro susceptibility to some of these agents if only routine susceptibility testing is performed.