Abbott i-STAT 1 System Manual page 418

Thiocyanate
Notes:
1) Bromide has been tested at two levels: the CLSI recommended level and a therapeutic
plasma concentration of 2.5 mmol/L. The latter is the peak plasma concentration associated
with halothane anesthesia, in which bromide is released. APOC has not identified a therapeutic
condition that would lead to levels consistent with the CLSI recommended level. Bromide at a
concentration of 37.5 mmol/L decreased i-STAT BUN/UREA results and increased the rate of
BUN/UREA star (***) outs, while a therapeutic range of bromide (2.5 mmol/L) did not significantly
interfere with i-STAT BUN/UREA results.
2) Hydroxyurea is a DNA synthesis inhibitor used in the treatment of various forms of cancer,
sickle cell anemia, and HIV infection. This drug is used to treat malignancies including melanoma,
metastatic ovarian cancer, and chronic myelogenous leukemia. It is also used in the treatment
of polycythemia vera, thrombocythemia, and psoriasis. At typical doses ranging from 500 mg to
2 g/day, concentrations of hydroxyurea in patients' blood may be sustained at approximately 100
to 500 μmol/L. Higher concentrations may be observed soon after dosing or at higher therapeutic
doses.
3) Nithiodote (sodium thiosulfate) is indicated for the treatment of acute cyanide poisoning. The
journal article titled "Falsely increased chloride and missed anion gap elevation during treatment
with sodium thiosulfate" indicated that sodium thiosulfate could be used in the treatment of
calciphylaxis indicating that "the highest concentration likely to be seen in plasma [is] after infusion
of a 12.5 g dose of sodium thiosulfate pentahydrate. Assuming that the 12.5 g dose of sodium
thiosulfate pentahydrate is distributed in a typical blood volume of 5 L with a hematocrit of 40%, the
peak sodium thiosulfate plasma concentration expected is 16.7 mmol/L."
*It is possible that other interfering substances may be encountered. The degree of interference at concentrations other than those listed might not
be predictable.
BUN - 4
Art: 714176-01Q
6.9
7
Rev. Date: 15-Jul-16