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Test Code DIA Diazepam and Nordiazepam, Serum

Test Down Notes

This test is temporarily unavailable due to instrumentation issues. As an alternate, order ZW86 (1501SP). For additional details, see test update here.

Reporting Name

Diazepam and Nordiazepam, S

Useful For

Assessing compliance

 

Monitoring for appropriate therapeutic level

 

Assessing diazepam toxicity

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum Red


Specimen Required


Collection Container/Tube: Red top (Serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 0.5 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Red Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Reference Values

Therapeutic concentrations

Diazepam and Nordiazepam: 200-2,500 ng/mL

Day(s) Performed

Monday, Wednesday

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80299

LOINC Code Information

Test ID Test Order Name Order LOINC Value
DIA Diazepam and Nordiazepam, S 49044-1

 

Result ID Test Result Name Result LOINC Value
8629 Diazepam 3548-5
2475 Nordiazepam 3537-8
2459 Diazepam and Nordiazepam 16757-7

Interpretation

For seizures:

Serum concentrations are not usually monitored during early therapy because response to the drug can be monitored clinically as seizure control. If seizures resume despite adequate therapy, another anticonvulsant must be considered.

 

Toxicity is commonly seen when diazepam plus nordiazepam concentrations exceed 3000 ng/mL. Adverse effects of benzodiazepines in therapeutic doses usually reflect the drug's pharmacology and include sedation, slurred speech, and ataxia. Respiratory depression/arrest may occur with large overdoses or following rapid intravenous injection with short-acting benzodiazepines.

Clinical Reference

1. Langman LJ, Bechtel LK, Meier BM, Holstege C. Clinical toxicology. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:832-887

2. Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. WB Saunders Company; 2011:Table 60.2

Report Available

3 to 7 days

Method Name

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

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Neurology Specialty Testing Client Test Request (T732)

-Therapeutics Test Request (T831)