Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

EEPC
83917
inhibitor class. It is effective in treating symptoms of depression, including physical pain associated with
depression; other uses include therapy of neuropathic pain, fibromyalgia, and urinary stress incontinence.
Duloxetine also inhibits serotonin uptake in human platelets, and may be associated with potentiation of
bleeding. Duloxetine undergoes extensive hepatic biotransformation to numerous inactive metabolites.
The drug is metabolized by CYP1A2 and CYP2D6, with moderate potential for drug interactions
(duloxetine is both a substrate and a moderate inhibitor of CYP2D6). The mean elimination half-life is
12.5 hours with steady-state concentrations occurring in about 3 days. Specimens for therapeutic
monitoring should be drawn immediately before the next scheduled dose (ie, trough). Duloxetine is not
recommended for patients with hepatic impairment, substantial alcohol use, or chronic liver disease. Use
in patients with renal disease significantly increases exposure to duloxetine due to decreased elimination.
Patients with mild-to-moderate renal dysfunction should be monitored closely; use of duloxetine is not
recommended in end-stage renal disease.
Useful For: Monitoring serum concentration during therapy Evaluating potential toxicity The test
may also be useful to evaluate patient compliance
Interpretation: Therapeutic ranges are not well-established, but literature suggests that patients
receiving duloxetine monotherapy for depression responded well when trough concentrations were 60 to
120 ng/mL. Higher levels may be tolerated by individual patients. The therapeutic relevance of this
concentration range to other uses of duloxetine therapy is currently unknown.
Reference Values:
60-120 ng/mL
Clinical References: 1. Westanmo AD, Gayken J, Haight R: Duloxetine: a balanced and selective
norepinephrine- and serotonin-reuptake inhibitor. Am J Health-Syst Pharm 2005;62:2481-2490 2.
Waldschmitt C, Vogel F, Pfuhlmann B, Hiemke C: Duloxetine serum concentrations and clinical
effects. Data from a therapeutic drug monitoring (TDM) survey. Pharmacopsychiatry 2009;42:189-193
Eastern Equine Encephalitis Antibody Panel, IgG and IgM,
Spinal Fluid
Clinical Information: Eastern equine encephalitis (EEE) is within the alphavirus group. It is a
low-prevalence cause of human disease in the Eastern and Gulf Coast states. EEE is maintained by a
cycle of mosquito/wild bird transmission, peaking in the summer and early fall, when man may become
an adventitious host. The most common clinically apparent manifestation is a mild undifferentiated
febrile illness, usually with headache. Central nervous system involvement is demonstrated in only a
minority of infected individuals, and is more abrupt and more severe than with other arboviruses, with
children being more susceptible to severe disease. Fatality rates are approximately 70%. Infections with
arboviruses can occur at any age. The age distribution depends on the degree of exposure to the
particular transmitting arthropod, relating to age, sex, and occupational, vocational, and recreational
habits of the individuals. Once humans have been infected, the severity of the host response may be
influenced by age.
Useful For: Aiding the diagnosis of Eastern equine encephalitis
Interpretation: Detection of organism-specific antibodies in the cerebrospinal fluid (CSF) may
suggest central nervous system infection. However, these results are unable to distinguish between
intrathecal antibodies and serum antibodies introduced into the CSF at the time of lumbar puncture or
from a breakdown in the blood-brain barrier. The results should be interpreted with other laboratory and
clinical data prior to a diagnosis of central nervous system infection.
Reference Values:
IgG: