AMITRIPTYLINE \ NORTRYPTYLINE

Code
900.0325
Name
AMITRIPTYLINE \ NORTRYPTYLINE
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Tricyclic Antidepressant; TCA; Aventyl; Elavil; Nortriptyline
CPT Codes
80152, 80182
Site
SBMF
Reference Test
45501
ATLAS Test Code

AMITRIP

Specimen Information

Type

Red top (serum) or Lavender top (EDTA) tube

Volume

1.0 ml

Transport Info

Centrifuge and immediately transfer serum or plasma to separate plastic tube Refrigerated

Fasting Required?
False
Patient Instructions

Reference Range

Therapeutic Range Total drug: 95-250 ng/mL Toxic: > 500 ng/mL

Methodology

Quantitative Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)

Clinical Significance

Use: Therapeutic Drug Monitoring Tricyclic antidepressants (TCAs) are a class of highly basic and hydrophobic compounds used extensively to counteract primary (endogenous) depression in humans.TCAs undergo extensive hepatic metabolism by two common pathways, each resulting in more polar metabolites. Several of the dealkylated metabolites themselves are psychoactive drugs and are monitored as well. The parent drugs and their active metabolites are highly bound to plasma and tissue proteins. Plasma concentration and rate of metabolism depend on factors such as hepatic status of the patient, and concomitant use of drugs which can either inhibit or promote the hepatic enzyme responsible for metabolism.Structurally, TCAs consists of two aromatic rings connected by a seven-member ring containing a basic side chain. Prominent members of this class can be divided into two groups, Tertiary amines and Secondary amines. This assay is designed for the quantitative measurement of the tertiary amines Amitriptyline, Imipramine, Doxepin, Trimipramine, and the secondary amines Nortriptyline, Desipramine and Desmethyl Doxepin in serum or plasma.

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