Lorazepam

Last Modified: 9/28/2021 11:59:37 AM


Medical Necessity Documentation:  
Client Notes:  
Patient Preparation: Timing of specimen collection: Pre-dose (trough) draw - At steady state concentration
Specimen Requirements:

2.0 mL  Plasma from a Grey Top Tube - Na Flouride K+ in a Plastic Vial
Collection Instructions: Pre-dose (trough) draw 

Centrifuge and separate from cells within 2 hours of collection. 

Do not collect in a
Minimum Volume: 1.0 mL
Transport & Storage: Temperature/Stability: 3 days Refrigerated
Rejection Criteria: Serum Separator Tube (SST or PST): Plasma or whole blood collected in light blue (sodium citrate). Hemolyzed specimens.
Reference Range:
Dose-Related Range: 50-240 ng/mL - Dose (Adult): 1-10 mg/d
Toxic: Greater than 300 ng/mL
Critical Ranges:  
Test Comments:  
Methodology: Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Clinical Significance:  
Documentation:  Optimize drug therapy and monitor patient adherence
Custom Panel: No

PRODUCTION SCHEDULE

Turn Around Time: 1 to 5 days
Days Performed: Tuesday, Thursday
Sites Performed: ARUP Lab
PHL Test Code: LORAZ
EPIC Test Code: LAB2505
Send Out Test Code: 0090181
Alternate Test Names: Ativan; LORAZ
Included Tests:  
CPT Coding: 80346

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