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Mayo Test ID SECOS Secobarbital, Serum


Specimen 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. Collect specimen immediately before next scheduled dose.

2. Centrifuge and aliquot serum into plastic vial within 2 hours of collection.


Useful For

Monitoring secobarbital therapy

Method Name

Gas Chromatography Mass Spectrometry (GC-MS)

Reporting Name

Secobarbital, S

Specimen Type

Serum Red

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

Clinical Information

Secobarbital is a short-acting barbiturate with hypnotic properties used as a preanesthetic agent and in the short-term treatment of insomnia.(1,2)

 

Secobarbital 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 1.6 to 1.9 L/kg, and about 46% to 70% of a dose is bound to plasma proteins. Metabolism takes place in the liver primarily via hepatic microsomal enzymes. The half-life of secobarbital is about 15 to 40 hours (mean: 28 hours).(2,3)

Reference Values

Therapeutic concentration: 1.0-2.0 mcg/mL

Toxic concentration: >5.0 mcg/mL

Interpretation

Secobarbital concentrations above 5 mcg/mL have been associated with toxicity.

Cautions

The concentration at which toxicity occurs varies and results should be interpreted in light of the clinical situation.

 

Specimens collected in serum gel tubes are not acceptable because the drug can absorb on the gel and lead to falsely decreased concentrations.

Clinical Reference

1. Langman LJ, Bechtel LK, Holstege CP. Chapter 43: Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:454-454.e484

2. Baselt RC. Disposition of Toxic Drugs and Chemical in Man. 12th ed. Biomedical Publications; 2020.

3. Milone MC, Shaw LM. Chapter 42: Therapeutic Drugs and Their Management. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:420-453

4. Mihic SJ, Mayfield J. Hypnotics and Sedatives. In: Brunton LL, Knollmann BC, eds. In: Goodman and Gilman's: The Pharmacological Basis of Therapeutics, 14th ed. McGraw-Hill Education; 2023

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)

Day(s) Performed

Thursday

Report Available

3 to 9 days

Specimen Retention Time

2 weeks

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80299

LOINC Code Information

Test ID Test Order Name Order LOINC Value
SECOS Secobarbital, S 4028-7

 

Result ID Test Result Name Result LOINC Value
8243 Secobarbital, S 4028-7