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HelpTest Code BUTAS Butalbital, Serum
Reporting Name
Butalbital, SUseful For
Monitoring butalbital therapy
Method Name
Gas Chromatography-Mass Spectrometry (GC-MS)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Serum RedSpecimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (Serum gel/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1.5 mL
Collection Instructions:
1. Draw blood immediately before next scheduled dose.
2. Centrifuge and aliquot serum into a plastic vial within 2 hours of collection.
Specimen Minimum Volume
0.6 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days | |
| Ambient | 14 days | ||
| Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
Therapeutic concentration: <10 mcg/mL
Toxic concentration: ≥10 mcg/mL
Day(s) Performed
Thursday
CPT Code Information
80299
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BUTAS | Butalbital, S | 6895-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8427 | Butalbital, S | 6895-7 |
Clinical Information
Butalbital, a short-acting barbiturate with hypnotic properties, is used in combination with other drugs such as acetaminophen, salicylate, caffeine, and codeine.(1)
Butalbital is administered orally. The duration of its hypnotic effect is about 3 to 4 hours. The drug distributes throughout the body, with a volume of distribution of 0.8 L/kg, and about 26% of a dose is bound to plasma proteins. The half-life of butalbital is about 35 to 88 hours. Excretion occurs mainly in the urine.(1,2)
Interpretation
Butalbital concentrations of 10 mcg/mL or greater have been associated with toxicity.
Cautions
Specimens collected in serum gel tubes are not acceptable because the drug can absorb on the gel and lead to falsely decreased concentrations.
Method Description
Barbiturates are extracted from serum using solid-phase extraction techniques. The serum is buffered and eluted with organic solvent. The organic phase is dried, reconstituted, and analysis performed by gas chromatography-mass spectrometry using selected ion monitoring. The assay utilizes deuterated barbiturates as internal standards.(Unpublished Mayo method)