Tobramycin
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
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| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
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| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Tobramycin | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
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Test ID :
TOBRA
Test Workstation :
Sendouts
Specimen Type:
Blood
Tube Type:
Green top (lithium heparin) tube
Alternate Tube Type:
Red Top, Gold Top SST,
Collection Volume:
Draw 3 ml (0.8 ml minimum)
Minimum Volume:
0.3 ml serum/plasma
Preferred Volume:
1.0 ml serum/plasma
Storage:
Shipping- Send Refrigerated
Availability:
24 hours/day, 7 days/week
Special Instructions:
For therapeutic monitoring, peak levels should be drawn 60 minutes after an intramuscular injection, 30 minutes after the end of a 30-minute IV Infusion or immediately after a 60-minute IV infusion. Draw trough levels immediately prior to next dose.
Lab/Phone:
330-543-8418
TAT:
8 hours
Additional Info:
See report for Reference Ranges.
Specimen sent to University Hospitals, Cleveland.
Order test as Peak, Trough, or Random.
CPT Code:
80200
Synonyms:
Nebcin, Tobrex
