Do evacuated blood collection tubes interfere with therapeutic drug monitoring?
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The influence of various brands of evacuated blood collection systems (the old type, red stoppered Vacutainer®; the new type, blue stoppered Vacutainer®; Monoject® and Venoject®) on therapeutic drug monitoring was investigated. No interferences were found in the assay of ethosuximide, phenobarbital, phenytoin, valproic acid, digitoxin, digoxin, procainamide, gentamicin and theophylline.
Using Monoject® and old type Vacutainer® tubes, lower levels were found in the disopyramide assay: 91.3±4.6% (p<0.05) and 91.7±7.0% (not significant) respectively, and in the quinidine assay: 82.8±6.7% (p<0.02) and 83.9±4.4% (p<0.001) respectively as compared with glass tubes. In the carbamazepine assay a decrease was found in the Monoject® tubes only: 93.7±1.7% (p<0.01). The stoppers of Monoject® tubes and the old type Vacutainer® tubes contained the plasticizer tris(2-butoxyethyl)phosphate (tbep), which has been shown to be a potent inhibitor of the binding of several drugs to α1-acid glycoprotein.
Using the new type Vacutainer® and the Venoject®, no interferences were found.
KeywordsDigoxin Gentamicin Theophylline Carbamazepine Valproic Acid
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