All samples should be collected 6 - 12 hours post dose.
Tubes containing gel (SST and PST) are NOT acceptable
Units: umol/L
|
Therapeutic range: 0.54 - 2.16 (150-600ug/L) |
Uncertainty of Measurement: 14% umol/L
Performed twice a week.
Principle : Liquid Chromatography Mass Spectrometry (LCMS)
Perhexiline maleate monitoring
Short term treatment, while awaiting coronary re-vascularisation:
The perhexiline level should be measured 72 - 96 h after the start of therapy. If the patient develops nausea or dizziness, or has a concentration > 2.16 umol/L (600 ug/L), the dose should be reduced and the level repeated 72 h later. A level > 2.16 umol/L also identifies patients who are likely to be slow metabolisers.
If below 2.16 umol/L (600 ug/L), it should be repeated 14 days later, by which time the patient should have reached a steady state.
Long term treatment:
A perhexiline level is recommended 14 days after the start of therapy. At this stage all patients should have reached a steady state and rapid metabolisers will have a concentration close to the therapeutic range of 0.54 - 2.16 umol/L (150 - 600 ug/L), while slow metabolisers will have a concentration at least twice the therapeutic range.
If a dose alteration is required, the level should be measured again 14 days later, remembering that it may take up to 3 months for a slow metaboliser to reach a steady state.
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402
Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052
Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427
Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427
Dr. Hima Madhavaram, Toxicologist: ext 22057
Centrifuge and separate blood as soon as possible after collection.
If sending within Auckland then sample can be sent refrigerated (2-8 degrees) or at ambient temperature (8-24 degrees).
If sending from outside Auckland then send sample refrigerated (2-8 degrees).
Note: If temperature during shipping is likely to exceed 24 degrees then results may not always be reliable.