Test Directory - Understand Your Tests.

Test DIRECTORY

Explore our comprehensive menu of laboratory tests designed to support accurate, reliable results across every specialty.

APG LAB's test directory provides a comprehensive list of specialty and general laboratory testing services.

# A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

There are currently 15 names in this directory beginning with the letter N.

Naloxone, UR, MS Confirm

Expected Turnaround Time 4 - 6 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine (random) Volume 10 mL Minimum Volume 3 mL Container Plastic urine container without preservative Storage Instructions Room temperature Causes for Rejection Urine in preservative tube Test Details Use Detect the presence of Naloxone Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Liquid chromatography tandem mass spectrometry (LC/MS-MS)

Narcolepsy Evaluation

Special Instructions If you have questions, please telephone HLA customer service at 800-533-1037 for assistance in selecting the appropriate HLA test for the patient. Expected Turnaround Time 3 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Whole blood or buccal swabs Volume 7 mL or four buccal swabs Minimum Volume 3 mL or four buccal swabs Container Lavender-top (EDTA) tube or four buccal swabs in a sealed envelope (buccal swab kit). If submitting buccal swabs, please use the kit provided by LabCorp. To obtain the buccal swab kit or to discuss other specimen types, please telephone 800-533-1037. Storage Instructions Maintain specimen at room temperature. Protect from extreme heat or cold. Causes for Rejection Incorrect specimen container (tube type); yellow-top (ACD) tube Test Details Use HLA DQB1*06:02 and HLA DQA1*01:02 are associated statistically with narcolepsy and are sometimes used as tests in support of that diagnosis. Limitations Even with appropriate precautions, an occasional specimen may not be satisfactory for testing. In such cases, fresh specimens should be collected for retesting. Narcolepsy-associated HLA alleles are not diagnostic, but they are useful in stratifying risk. Methodology Polymerase chain reaction (PCR)/sequence-specific oligonucleotide probes (Luminex®)

Natural Killer Cell Surface Antigen (CD3-CD56+ Marker Analysis)

Test Includes Percentage CD3-CD56+ natural killers (NK+); absolute CD3-CD56+ natural killers (NK+); absolute lymphocyte count Expected Turnaround Time 1 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Whole blood Volume Fill tube(s) to capacity. Container Lavender-top (EDTA) tube and yellow-top (ACD-A) or (ACD-B) tube Collection Invert tube 8 to 10 times immediately after collection. To preserve cellular viability, collect specimen so it will arrive in the laboratory within 48 hours of collection. Indicate date and time of venipuncture on the tube(s) and on the test request form. Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 2 days Refrigerated Unstable Frozen Unstable Freeze/thaw cycles Unstable Causes for Rejection Hemolysis; specimen refrigerated or frozen; clotted specimen; contaminated specimen Test Details Use Determine levels of natural killer cells in circulation; monitor immune stimulation therapy Methodology Flow cytometry Reference Interval Reference intervals for adults have been established by the laboratory. See table. CD3_CD56+ Reference Intervals for Lymphocyte Immunophenotyping Age 95% Confidence Interval Percentage Cells/mm3 Minimum Maximum Minimum Maximum Pediatric reference intervals are from Comans-Bitter WM, de Groot R, van den Beemd R, et al. Immunophenotyping of blood lymphocytes in childhood. Reference values for lymphocyte subpopulations. J Pediatrics. 1997 Mar; 130(3):388-393. Neonates 6 58 100 1900 1 wk to 2 m 3 23 200 1400 2 to 5 m 2 14 100 1300 5 to 9 m 2 13 100 1000 9 to 15 m 3 17 200 1200 15 to 24 m 3 16 100 1400 2 to 5 y 4 23 100 1000 5 to 10 y 4 26 90 900 10 to 16 y 6 27 70 1200 Adults 1 19 24 406 Additional Information Natural killer (NK) cells are large granular lymphocytes that mediate MHC-unrestricted cytotoxicity against virus-infected and malignant cells and manufacture a number of cytokines following stimulation of the immune system.

NBOMe Hallucinogens, Screen and Confirmation, Urine

Test Includes 25I-NBOMe; 2C-C-NBOMe; 25H-NBOMe Expected Turnaround Time 10 - 14 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Specimen Requirements Specimen Urine (random) Volume 5 mL Minimum Volume 1 mL Container Plastic urine container without preservative Storage Instructions Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen. Causes for Rejection Urine from preservative tube Test Details Use Detect the presence of NBOMe hallucinogens Methodology Initial presumptive testing by liquid chromatography/mass spectrometry (LC/MS-MS) at a testing threshold of 1.0 ng/mL; presumptive positives confirmed by definitive liquid chromatography/mass spectrometry (LC/MS-MS) at a testing threshold of 1.0 ng/mL

Neopterin

Expected Turnaround Time 5 - 8 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum or plasma Volume 0.8 mL Minimum Volume 0.3 mL (Note: This volume does not allow for repeat testing.) Container Red-top tube, gel-barrier tube, or lavender-top (EDTA) tube Collection If tube other than a gel-barrier tube is used, transfer separated serum or plasma to a plastic transport tube. Storage Instructions Refrigerate. Protect from exposure to ultraviolet light and sunlight. Test Details Use Increased levels of neopterin are found during impaired renal function and viral infection in transplant patients. Elevated levels are also indicators for conditions related to impaired cellular immunity. Limitations This procedure may be considered by Medicare and other carriers as investigational and, therefore, may not be payable as a covered benefit for patients. Methodology Enzyme immunoassay (EIA) Reference Interval Adults: <2.5 ng/mL Additional Information Neopterin, a pyrazolopyridine compound, is produced by macrophages after induction by interferon γ and serves as a marker of cellular immune system activation. Measurable levels of neopterin have been detected in both the serum and urine of patients suffering from various types of malignancies1 and viral infections. Changes in neopterin concentrations in serum or urine can predict complications such as graft rejection in organ transplant recipients. Elevated neopterin levels are found in autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus (SLE). Neopterin levels can be used as prognostic predictors for certain types of malignancies. Measurement of neopterin levels has particular value for monitoring patients infected with HIV. Neopterin is eliminated primarily in the urine, so evaluation of urinary neopterin levels may be useful in assessing activation of the cellular immunity system even in the absence of typical clinical symptoms, since a correlation has been observed with the course of diseases involving cellular immunity activation and urinary neopterin levels.

Nettle

Expected Turnaround Time 3 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Individual Allergens Related Documents Sample Report Specimen Requirements Specimen Serum Volume 0.2 mL Container Red-top tube or gel-barrier tube Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 3 months Freeze/thaw cycles Stable x3 Test Details Methodology Thermo Fisher ImmunoCAP®

Neuroblastoma Monitor Profile

Test Includes Ferritin; lipid-associated sialic acid (LASA), serial monitor report; neuron-specific enolase (NSE), serial monitor report Special Instructions The account must submit the patient's Social Security number to monitor. Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample. Expected Turnaround Time 4 - 7 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum Volume 4 mL Minimum Volume 2 mL Container Red-top tube or gel-barrier tube Collection If a red-top tube is used, transfer separated serum to a plastic transport tube. Storage Instructions Refrigerate Causes for Rejection Gross hemolysis; whole blood specimen; recently administered isotopes Test Details Use Monitor the course of neuroblastoma, patient response to treatment, and disease recurrence Limitations This profile should not be used as a diagnostic or screening test for cancer. The LASA test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. The results of the NSE test are labeled for research purposes only by the assay's manufacturer. The performance characteristics of this assay have not been established by the manufacturer. The result should not be used for treatment or for diagnostic purposes without confirmation of the diagnosis by another medically established diagnostic product or procedure. The performance characteristics were determined by LabCorp. Methodology See individual tests.

Nickel, Urine

Synonyms Ni, Urine Test Includes Creatinine, urine; nickel, urine; nickel:creatinine ratio; nickel, urine (24-hour) Special Instructions State 24- hour volume on the request form, if applicable. Do not use preservative. Preservatives used for routine analysis may contain mercuric oxide (ie, Stabilur), which interferes with all metal testing. If both urinalysis and metal testing are ordered, please submit a separate urine specimen (containing no additive) for the metal testing. Expected Turnaround Time 1 - 3 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Nickel, Plasma Urine Specimens Related Documents Sample Report Specimen Requirements Specimen Urine (random or 24-hour) Volume 5 mL Minimum Volume 1.5 mL Container Plastic urine container, no preservative Collection Optional protocol: Instruct the patient to void at 8 AM and discard the specimen. Then collect all urine including the final specimen voided at the end of the 24-hour collection period (ie, 8 AM the next morning). Avoid contact with metal during collection. Screw the lid on securely. Storage Instructions Maintain specimen at room temperature. Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Test Details Use Monitor exposure to nickel Limitations This test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration. Methodology Inductively-coupled plasma/mass spectrometry (ICP/MS) Reference Interval • Environmental exposure: 0.0−9.9 μg/g creatinine; 0.0−7.0 μg/24 hou

Nicotine/Cotinine, Screen and Confirmation, Urine

Expected Turnaround Time 1 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Urine Volume 20 mL Container Plastic urine container Storage Instructions Maintain specimen at room temperature. If arrival at lab will extend beyond seven days, refrigerate. Test Details Use Detect use of nicotine products. Methodology Initial testing by immunoassay (IA); confirmation of positives by mass spectrometry (MS

Niemann-Pick Disease, DNA Analysis

Synonyms Acid Sphingomyelinase Gene Jewish Heritage Test Special Instructions If cultured cells are needed, an additional 7-12 days may be required. Additional culture fee may be included. Expected Turnaround Time 9 - 15 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Chromosome Analysis, Instability Syndrome Specimen Requirements Specimen Whole blood, amniotic fluid, chorionic villus sample (CVS) (submission of maternal blood is required for fetal testing), or LabCorp buccal swab kit (buccal swab collection kit contains instructions for use of a buccal swab) Volume 7 mL whole blood, 10 mL amniotic fluid, 20 mg CVS, or LabCorp buccal swab kit Minimum Volume 3 mL whole blood, 5 mL amniotic fluid, 10 mg CVS, or two buccal swabs Container Lavender-top (EDTA) tube, yellow-top (ACD) tube, sterile plastic conical tube or two confluent T25 flasks for fetal testing, or LabCorp buccal swab kit Storage Instructions Maintain specimen at room temperature or refrigerate. Causes for Rejection Frozen specimen; hemolysis; quantity not sufficient for analysis; improper container; one buccal swab; wet buccal swab Test Details Use Identification of carrier and affected individuals for four mutations associated with Neimann-Pick disease, types A and B. Prenatal testing is available. Limitations This test detects approximately 95% of the mutations responsible for Niemann-Pick disease, types A and B in Ashkenazi Jews. The mutations detected are L302P, R496L, fsP330, and ΔR608. Other mutations are not detected. Methodology Polymerase chain reaction (PCR); primer extension; flow-sorted bead array analysis Additional Information Niemann-Pick disease (OMIM 257200 and 607616) is a lysosomal storage disorder that is characterized by failure to thrive and hepatosplenomegaly. There are at least five different reported subtypes. This test only analyzes mutations found in types A and B and has a detection rate of 95% for Ashkenazi Jewish individuals. Approximately 1 in 90 persons of Ashkenazi Jewish descent are carriers for Niemann-Pick disease. Type A is the infantile form that generally leads to death in early childhood. Type B is often called the chronic or non-neuropathic form in which affected individuals have absence of neurologic involvement and prolonged survival. Type C has a slower onset of symptoms and is considered the juvenile form. Type D appears to be isolated to a certain population in Nova Scotia, and type E is adult-onset Niemann-Pick. This test does not provide information about types C, D, and E. This test has limited value for people of non-Ashkenazi Jewish ancestry, as the mutation detection rate is negligible. DNA test results must be combined with clinical information for the most accurate interpretation.

Nocardia, Aerobic Actinomycetes Susceptibility (AST)−Broth Dilution

Synonyms Nocardia Susceptibility Testing AFB Susceptibility Testing Susceptibility Testing, Nocardia Test Includes Susceptibility testing for amikacin, amoxicillin/clavulanic acid, ceftriaxone, ciprofloxacin, clarithromycin, imipenem, linezolid, minocycline, sulfamethoxazole/trimethoprim (SxT), and tobramycin. MIC values will be reported with CLSI interpretive comments. Expected Turnaround Time 14 - 28 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information Acid-fast (Mycobacteria) Antibiotic Susceptibilities Related Documents Sample Report Specimen Requirements Specimen Nocardia species or other aerobic actinomycetes isolated from a primary clinical specimen, on a submitted conventional solid medium (ie, Lowenstein-Jensen [LJ] slant, Sabouraud dextrose [SAB] slant, or similar) Volume Pure culture isolate on a conventional solid medium Container Conventional medium, tightly sealed, in etiologic agent packaging Storage Instructions Maintain media at room temperature. Causes for Rejection Broken transport tube or vial; specimen received in expired transport medium; mixed culture; unlabeled culture or name discrepancy between specimen and request label Test Details Use Determine the susceptibility of Nocardia species and/or other aerobic Actinomycetes isolates to a profile of antimicrobial agents. Routine susceptibility testing of Nocardia isolates is recommended since the Nocardia genus contains a heterogeneous group of organisms that has variable antibiotic susceptibilities. Limitations Susceptibilities cannot be reported if the organism fails to grow in the test medium. Susceptibilities cannot be performed on mixed cultures. Results of this test are labeled for research purposes only by the assay's manufacturer. The performance characteristics of this assay have not been established by the manufacturer. The result should not be used for treatment or for diagnostic purposes without confirmation of the diagnosis by another medically established diagnostic product or procedure. The performance characteristics were determined by LabCorp. Methodology Sensititre® broth microdilution (MIC)

Non-Alcoholic Fatty Liver Disease Advanced Fibrosis Rule-Out Cascade

Synonyms Fatty Liver Disease Liver Fibrosis NAFLD NASH Nonalcoholic Fatty Liver Disease Noninvasive Liver Biopsy Steatohepatitis Test Includes AST (SGOT) and Platelet Count; reflex to NASH FibroSure® that includes age, gender, height, weight; Alpha 2-Macroglobulins, Qn; Haptoglobin; Apolipoprotein A-1; Bilirubin, Total; GGT; ALT (SGPT) P5P; AST (SGOT) P5P; Cholesterol, Total; Glucose; Triglycerides Special Instructions The patient's age, gender, height, and weight at the time of collection must be submitted for FibroSure® testing. Expected Turnaround Time 1 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Information ASH FibroSure® Hepatitis C Virus (HCV) FibroSure® Related Documents For more information, please view the literature below. Non-Alcoholic Fatty Liver Disease Advanced Fibrosis Rule-Out Cascade LABupdate Specimen Requirements Specimen Serum and whole blood Volume Serum: 4.0 mL divided into two tubes, 0.5 for initial testing and 3.5 for possible reflex Whole blood: tube filled to capacity Minimum Volume Serum: 3.0 mL divided into two tubes, 0.5 for initial testing and 2.5 for possible reflex Whole blood: tube filled to capacity Container Gel-barrier tube or red-top tube and lavender-top (EDTA) tube Collection Serum: Separate from cells within 45 minutes of collection. Whole blood: Invert EDTA tube immediately 8 to 10 times once tube is filled at the time of collection. Storage Instructions Serum sample for initial testing and whole blood can be stored room temperature. Serum sample for possible reflex can be stored refrigerated a 2°C to 8°C for 72 hours. Patient Preparation Patient should be fasting for at least eight hours. Causes for Rejection Serum: Gross hemolysis; gross lipemia; improper labeling; nonfasting specimen; patient younger than 14 years of age. Whole blood: Frozen specimen; hemolysis; clotted specimen; tube not filled with minimum volume; improper labeling; transfer tubes with whole blood; specimen diluted or contaminated with IV fluid; specimen received with plasma removed; specimen collected in any anticoagulant other than EDTA. Test Details Use The cascade is intended for use in patients with non-alcoholic fatty liver disease (NAFLD) and suspected non-alcoholic steatohepatitis (NASH) with advanced fibrosis that include subjects with no alcohol-related disorders and any of the following: elevated liver function tests, obesity, type 2 diabetes, metabolic syndrome, imaging evidence of fat accumulation, dyslipidemia, polycystic ovary syndrome. These patients may be at high risk for progression to advanced liver fibrosis that can cause a fast progression to end-stage liver disease, hepatocellular carcinoma, and liver transplantation. Non-invasive blood biomarkers can help identifying those patients using rule-out approach. Liver biopsy is still required to definitively diagnose patients with NASH and NASH fibrosis. Limitations Clumping may cause false low platelet count. Platelet satellitism around neutrophils will cause a pseudothrombocytopenia. RBC or WBC fragments including fragmented fragile leucemic cells and neutrophil pseudoplatelets may cause falsely elevated counts. NASH FibroSure® is recommended for patients with suspected non-alcoholic fatty liver disease. It is not recommended for patients with other liver diseases. It is also not recommended in patients with Gilbert disease, acute hemolysis, acute hepatitis, acute inflammation of the liver, autoimmune hepatitis, extrahepatic cholestasis, transplant patients, and/or renal insufficiency patients. Any of these clinical situations may lead to inaccurate quantitative predictons of fibrosis. This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA). The FDA has determined that such clearance or approval is not necessary. Additional Information The cascade starts with AST to Platelet Ratio Index (APRI). APRI is reported to be a simple, non-invasive, and readily available laboratory test index that can stratify patients with NAFLD who are at high or low risk for significant fibrosis and cirrhosis with high degree of accuracy. If the APRI result stratifies the patient to be at low risk, the testing will stop and the result will be reported with the following comment: "Low risk for liver fibrosis, consider monitoring APRI every 2 years." If the APRI result stratifies the patient to be at high risk, the testing will stop and the result will be reported with the following comment: "High risk for liver fibrosis, consider liver biopsy." If the APRI result stratifies the patient to be at intermediate risk, the testing cascade will reflex to NASH FibroSure®. This test is a non-invasive assessment of liver status in patients with NAFLD. Quantitative results of 10 biochemicals in combination with age, gender, height, and weight are analyzed using a computational algorithm to provide a quantitative surrogate marker (0.0-1.0) of liver fibrosis, hepatic steatosis, and non-alcoholic steatohepatitis (NASH). The absence of steatosis precludes the diagnosis of NASH. If NASH FibroSure® result stratifies the patient to be at low risk, the testing will stop and the result will be reported with the following comment: "Low risk for liver fibrosis, consider monitoring APRI every 2 years." If NASH FibroSure® result stratifies the patient to be at high risk, the testing will stop and the result will be reported with the following comment: "High risk for liver fibrosis, consider liver biopsy."

Nontuberculous Slowly-growing Mycobacterium Susceptibility−Broth Dilution

Synonyms M kansasii Susceptibility Testing AFB Susceptibility Testing MOTT Susceptibility Testing Slow-grower Susceptibility Testing Test Includes Susceptibility testing for amikacin, ciprofloxacin, clarithromycin, ethambutol, linezolid, streptomycin, and sulfamethoxazole-trimethoprim Related Information Acid-fast (Mycobacteria) Antibiotic Susceptibilities Acid-fast (Mycobacteria) Smear and Culture With Reflex to Identification and Susceptibility Testing Related Documents Sample Report Specimen Requirements Specimen Slowly-growing mycobacteria, not M tuberculosis, isolated from a primary clinical specimen, on a submitted AFB conventional solid medium, or an AFB broth medium Volume Pure culture isolate on an AFB conventional solid medium or a minimum of 1 mL of AFB broth medium Container Conventional or broth medium, tightly sealed, in etiologic agent packaging Storage Instructions Maintain media at room temperature. Causes for Rejection Specimen received in leaking or in broken transport tube or vial; specimen received in expired transport medium; mixed culture; unlabeled culture or name discrepancy between specimen and request label Test Details Use Determine the susceptibility of nontuberculous slowly-growing mycobacterial isolates to a profile of antimycobacterial agents. Interpretive categories for MICs are not yet available due to lack of clinical trial data that would indicate the clinical efficacy.1,2 For the unusual mycobacteria, susceptibility data is often useful as an aid in identification. Limitations Susceptibilities cannot be reported if the organism fails to grow in the test medium. Susceptibilities cannot be performed on mixed cultures. An organism identification is required prior to reporting susceptibility results. Results of this test are labeled for research purposes only by the assay's manufacturer. The performance characteristics of this assay have not been established by the manufacturer. The result should not be used for treatment or for diagnostic purposes without confirmation of the diagnosis by another medically established diagnostic product or procedure. The performance characteristics were determined by LabCorp. Methodology Sensititre® broth microdilution (MIC) Additional Information Failure to take all drugs in a multidrug regimen can lead to a shift toward resistant organisms and treatment failure.3 Susceptibility testing to rifampin is the only drug currently recommended for primary susceptibility testing of M kansasii.2 Isolates susceptible to rifampin are susceptible to rifabutin. Test results are not intended to be used as the sole means for patient management.

Norpropoxyphene Confirmation, Urine

Synonyms Darvocette® Darvon® Norpropoxyphene Test Includes Confirmation by mass spectrometry (MS) Special Instructions Chain-of-custody documentation is required for samples submitted for preëmployment, random employee testing, and forensic purposes. For other applications, use the standard request form. Please mark chain-of-custody test number on the request form. Expected Turnaround Time 1 - 4 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Urine Volume 20 mL Container Use plastic urine drug bottle and tamper-evident seal for forensic specimen. Collection kits are available by request from the laboratory. Collection Urine temperature monitoring is recommended for samples to be tested for medicolegal purposes. Storage Instructions Maintain specimen at room temperature. If arrival extends beyond seven days, then refrigerate. Causes for Rejection Quantity not sufficient for analysis; improper specimen (serum, plasma, blood); incomplete chain-of-custody documentation; incomplete specimen identification Test Details Use Drugs of abuse testing Methodology Mass spectrometry (MS) Reference Interval Cutoff: 200 ng/mL Additional Information Propoxyphene is an analgesic structurally similar to methadone. Its metabolite, norpropoxyphene is also pharmacologically active. Toxic effects include nausea, vomiting, and progressive central nervous system depression. Peak serum level occurs two hours postural dose, half-life is 8 to 24 hours. Propoxyphene can also be measured in urine as part of a drug of abuse test.

Nortriptyline

Synonyms Aventyl® Pamelor® Expected Turnaround Time 2 - 5 days Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary. Related Documents Sample Report Specimen Requirements Specimen Serum or plasma Volume 1 mL Minimum Volume 0.3 mL Container Red-top tube, lavender-top (EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant. Collection Transfer separated serum or plasma to a plastic transport tube. For therapeutic monitoring, collect specimen immediately prior to next dose. Storage Instructions Room temperature Stability Requirements Temperature Period Room temperature 14 days Refrigerated 14 days Frozen 14 days Freeze/thaw cycles Stable x3 Causes for Rejection Gel-barrier tube Test Details Use Nortriptyline, the N-demethylated metabolite of amitriptyline, is as effective as imipramine in the treatment of depressive episodes of major depression and bipolar disorder. It may also be useful in dysthymic disorder and atypical depression. Plasma concentrations 150−175 ng/mL are often associated with a suboptimal response in patients with major depression; therefore, excessive dosage may diminish responsiveness. In addition, active metabolites of nortriptyline may accumulate in elderly patients, and toxic side effects may develop despite plasma nortriptyline concentrations 500 ng/mL Additional Information Nortriptyline, a tricyclic antidepressant, is a derivative and metabolite of amitriptyline and is used to treat endogenous depression. The half-life of nortriptyline is 20 to 80 hours. Nortriptyline may be associated with cholestasis and cholestatic jaundice. Hematological consequences include agranulocytosis, purpura, and thrombocytopenia. Other side effects include a host of GI, endocrinologic, allergic, anticholinergic, cardiovascular, and neurologic disorders. All the tricyclic antidepressants have significant drug interactions. Being potent inducers of hepatic drug-metabolizing enzymes, particularly CYP3A4, CYP1A2, and CYP2C9, the antiepileptic drugs, carbamazepine, phenytoin, phenobarbital, and primidone stimulate the oxidative transformation of concurrently prescribed antidepressants.1 This results in decreased drug levels of the antidepressant. To a lesser extent, co-administration of oxcarbazepine, topiramate, and felbamate can also result in decreased antidepressant levels. Other tricyclic antidepressant drug interactions: hydrocortisone, methylphenidate, and phenothiazines increase tricyclic levels; tricyclics impair the antihypertensive effectiveness of clonidine and guanethidine; tricyclics and alcohol produce additive sedative effects, tricyclics and antiparkinsonism agents have potent anticholinergic side effects, and tricyclics and MAO inhibitors should not be co-administered because of the potential for antihypertensive and CNS crises. Tricyclics should be avoided in pregnant and lactating women because these drugs have not been established as safe. Geriatric patients are especially prone to postural hypotension, urinary retention, and sedation.2 In general, it has been reported that, “Therapeutic drug monitoring of antidepressants allows us to take into account the influence of factors such as co-medications, diet, smoking habit, impaired organ function, and compliance. Therapeutic drug monitoring and genotyping are thus complementary, and their combined use contributes to improve pharmacotherapy with antidepressants and other drugs.”3

Common Lab Tests

Complete Blood Count

This test, also known as a CBC, is the most common blood test performed. It measures the types and numbers of cells in the blood, including red and white blood cells and platelets. This test is used to determine general health status, screen for disorders and evaluate nutritional status. It can help evaluate symptoms such as weakness, fatigue and bruising, and can help diagnose conditions such as anemia, leukemia, malaria and infection.

Prothrombin Time

Also known as PT and Pro Time, this test measures how long it takes blood to clot. This coagulation test measures the presence and activity of five different blood clotting factors. This test can screen for bleeding abnormalities, and may also be used to monitor medication treatments that prevent the formation of blood clots.

Basic Metabolic Panel

This test measures glucose, sodium, potassium, calcium, chloride, carbon dioxide, blood urea nitrogen and creatinine which can help determine blood sugar level, electrolyte and fluid balance as well as kidney function. The Basic Metabolic Panel can help your doctor monitor the effects of medications you are taking, such as high blood pressure medicines, can help diagnose certain conditions, or can be part of a routine health screening. You may need to fast for up to 12 hours before this test.

Lipid

Panel

The lipid panel is a group of tests used to evaluate cardiac risk. It includes cholesterol and triglyceride levels.

Liver Panel

The liver panel is a combination of tests used to assess liver function and establish the possible presence of liver tumors.

Hemoglobin A1C

This test is used to diagnose and monitor diabetes.

Urinalysis

Often the first lab test performed, this is a general screening test used to check for early signs of disease. It may also be used to monitor diabetes or kidney disease.

Cultures

Cultures are used to test for diagnosis and treatment of infections. Illnesses such as urinary tract infections, pneumonia, strep throat, MRSA and meningitis can be detected and tested for appropriate antibiotic treatment.

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