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Tricyclic Level (TCA), Serum, STAT

Mnemonic:    [UNLIST LAB]
Name:    Tricyclic Level (TCA), Serum, STAT
Specimen:    2 mL serum from a Red top tube. Do not use GEL barrier tubes. Plasma is unacceptable.

Do not use gel tubes. Gel tubes are NOT acceptable.
Transport Temp:    Refrigerated
Ref Lab/Code:    Maine Medical Center TCA
  Method:    Fluorescence Polarization Immunoassay (FPIA)
Note:    Results are only an estimate of the total amount of TCAs and their metabolites.

Note: Serum TCA Screen is capable of detecting Amitriptyline, Clomipramine, Desipramine, Doxepin, Imipramine, Imipramine-N-oxide, Norclomipramine, Nordoxepin, Nortriptyline, Protriptyline, Trimipramine, Cyclobenzaprine, Cyproheptadine, Dothiepin, Perphenazine and Carbamazepine.

MMC Reference Values:
TCA concentrations >500 ng/mL are considered toxic. However, concentrations >250 ng/mL may indicate toxic levels of Doxepin and Chloripramine, while concentrations >45 ng/ml may indicate a toxic level of carbamazepine.
Processing Info:    Use a NorDx requisition; test performed at Maine Medical Center. Send courier directly to Maine Medical Center.

The requisitions are kept in the file cabinet. Write "STAT" and "Please phone to 795-2330 and Fax to 795-2345" on the requisition.

When the results are faxed back, give them to a tech to manually enter into PathNet.

Techs to result with the phrase TCA. Add in the result given on the report and units of measure after the test name. Check the text of the phrase against the MMC report before verifying.