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25410:PLAVIX MONITORING, PLATELET P2Y12
Alias Names:Clopidogrel (Plavix) / PY12 Assay / Prasugrel (Effient) / Ticlopidine (Ticlid)
Methodology:Whole blood platelet aggregation
Edit Date:6/11/2010
Performed:Daily
Released:Same day as tested
CPT Code:85576 x2
Specimen Collection Details
Collection:One 2 mL Greiner blue top tube (sodium citrate). Tube is designed to fill approximately halfway, to the small black line on the label. Do not overfill. Collect using a 21 gauge or larger needle. This draw should not be the first draw, even if it is necessary to draw and discard a first collection. Use a different tube (i.e., a red top tube), for the first draw. It is also recommended that the blue top tube not be drawn before a lavender top tube (EDTA). NOTE: Integrillin will invalidate testing. Verify with nursing that patient has not had Integrillin in the 48 hours prior to collection. Mix blue top tube by gentle inversion 5 times; do not over mix or put on a blood rocker, as this may result in platelet clumping. To collect specimen from an indwelling catheter, first remove at least 10 mL of blood from the line with a syringe and discard. Then obtain the specimen with a second syringe, at least 2.0 mL, and transfer to the collection tube.
Handling:Do not centrifuge or refrigerate . Keep ambient. Do not send through a pneumatic tube system. Deliver entire specimen to PeaceHealth Laboratories within 3 hours. Specimen must be tested within 4 hours of collection.
Stability:4 hours ambient. Unstable refrigerated or frozen.
Standard Volume:2 mL whole blood
Minimum Volume:2 mL whole blood
Transport:Ambient, in original tube.
Comments:Optimum time of testing is 4 hours after bolus dose, or 5 days after maintenance dose (75 mg/day) of Plavix. A frequent cause of unexpectedly low results is incorrect timing of specimen collection. Do not test patients who have taken a GP11b/111a inhibitor (Aggrastat or Integrillin) within two days, or ReoPro within two weeks. No other drugs (including Coumadin, heparin, or aspirin) affect this test. Low platelet count and anemia may affect results.
Rejection Criteria:Clotting or marked hemolysis; specimen refrigerated > 15 minutes or frozen; specimen sent through a pneumatic tube; specimen older than 4 hours.