Sorted By Test Name - Mayo Medical Laboratories

ETHO
80449
ETGL
8749
Interpretation: Dosage is guided by blood levels; the therapeutic range for ethosuximide is 40 to 100
mcg/mL Toxic concentration: > or =101 mcg/mL
Reference Values:
Therapeutic concentration: 40-100 mcg/mL
Toxic concentration: > or =101 mcg/mL
Clinical References: 1. Patsalos PN, Berry DJ, Bourgeois BF, et al: Antiepileptic drugs-best practice
guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug
monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia 2008;49(7):1239-1276 2. Moyer TP:
Therapeutic drug monitoring. In Tietz Textbook of Clinical Chemistry. Third edition. Edited by CA
Burtis, ER Ashwood. WB Saunders Company, Philadelphia, 1999, pp 862-905
Ethotoin (Peganoner)
Reference Values:
Reference Range: 8.0-20.0 ug/mL
Please note: The therapeutic range for ethotoin is not well established.
Many patients respond well to ethotoin concentrations up to 60 ug/mL.
Test Performed By:
Medtox Laboratories, Inc.
402 W. County Road D
St. Paul, MN 55112
Ethylene Glycol, Serum
Clinical Information: Ethylene glycol, present in antifreeze products, may be ingested accidentally
or for the purpose of inebriation or suicide. Ethylene glycol itself is relatively nontoxic, and its initial
central nervous system (CNS) effects resemble those of ethanol. However, metabolism of ethylene glycol
by alcohol dehydrogenase results in the formation of a number of acid metabolites, including oxalic acid
and glycolic acid. These acid metabolites are responsible for much of the toxicity of ethylene glycol.
Three stages of ethylene glycol overdose occur. Within the first few hours after ingestion, there is
transient excitation followed by CNS depression. After a delay of 4 to 12 hours, severe metabolic acidosis
develops from accumulation of acid metabolites. Finally, delayed renal insufficiency follows deposition
of oxalate in renal tubules. Ethylene glycol toxicity is treated with 4-methylpyrazole (4-MP; fomepizole)
or ethanol to saturate the enzyme alcohol dehydrogenase and prevent conversion of ethylene glycol to its
toxic metabolites.
Useful For: Confirming and monitoring ethylene glycol toxicity
Interpretation: Toxic concentrations are > or =20 mg/dL
Reference Values:
Toxic concentration: > or =20 mg/dL
Clinical References: 1. Porter W: Clinical toxicology. In Tietz Textbook of Clinical Chemistry,
Edited by CA Burtis, DE Bruns. Vol. 4. St. Louis, MO. Elsevier Saunders, 2006, pp. 1287-1369 2.
O'Brien CP: Drug addiction and drug abuse. In Goodman & Gilman's The Pharmacological Basis of
Therapeutics. Edited by LL Brunton, JS Lazo, KL Parker. Vol. 11. McGraw-Hill Book Company, Inc,
2006. Available at URL: http://www.accessmedicine.com/content.aspx?aID=941547 3. Anderson IB:
Ethylene Glycol and Other Glycols. In Poisoning & Drug Overdose. Edited by KR Olson, 5th Edition.
Available at URL: http://www.accessmedicine.com/content.aspx?aID=2683943
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