Aspartate Aminotransferase (AST, Serum

Glutamic
Oxaloacetic Transaminase [SGOT])
 Aspartate aminotransferase (AST) is an enzyme found
primarily in the heart, liver, and muscle.
It is released into the circulation after injury or death of
cells.
AST levels usually increase within 12 hours of the injury
and remain elevated for 5 days.
Normal Values
Female: 925 U/L (0.150.42 kat/L SI units)
Male: 1040 U/L (0.170.67 kat/L SI units)
Elderly: Slightly higher norms
Newborn: Norms two to three times higher
Possible Meanings of Abnormal
Values
Increased
Acute renal disease
Biliary obstruction
Bone metastases
Brain trauma
Cancer of the prostate
Cirrhosis
Eclampsia
Gangrene
Hemolytic disease
Hepatitis
Infectious mononucleosis
Liver cancer
Liver metastases
Liver necrosis
Malignant hyperthermia
Muscle inflammation
Myocardial infarction
Pancreatitis
Progressive muscular dystrophy
Pulmonary infarction
Reyes syndrome
Shock
Severe burns
Trauma

Decreased
Diabetic ketoacidosis
Beriberi
Hemodialysis
Uremia
Pregnancy
Contributing Factors to
Abnormal Values
Drugs that may increase AST levels: acetaminophen,
allopurinal, antibiotics, ascorbic acid, chlorpropamide,
cholestyramine, cholinergics, clofibrate, codeine, HMG-
CoA reductase inhibitors, hydralazine, isoniazid,
meperidine, methyldopa, morphine, oral contraceptives,
phenothiazines, procainamide, pyridoxine, salicylates,
sulfonamides, verapamil, vitamin A.
Drugs that may decrease AST levels: metronidazole,
trifluoperazine.
Interventions/Implications

Pretest
Explain to the patient the purpose of the test and the
need for a blood sample to be drawn.
When assessing for myocardial infarction, this test is
often performed on 3 consecutive
days, and again in 1 week, necessitating multiple
venipunctures.
No fasting is required before the test.
Procedure
A 7-mL blood sample is drawn in a red-top collection tube.
Gloves are worn throughout the procedure.

Posttest
Apply pressure 35 minutes at venipuncture site. Apply dressing,
periodically assessing for continued bleeding.
Teach the patient to monitor the site. If the site begins to bleed, the patient
should apply direct pressure and, if unable to control the bleeding, return to
the laboratory.
Label the specimen and transport it to the laboratory.
Report abnormal findings to the primary care providers.
Creatine Kinase and Isoenzymes
(CK, Creatine Phosphokinase
[CPK])
 Creatine kinase (CK) is an enzyme found primarily in the heart and skeletal
muscles, and in smaller amounts in the brain. When the total CK level is
substantially elevated, it usually indicates injury or stress to one or more of
these areas. When a muscle is damaged, CK leaks into the bloodstream.
Determining which isoenzyme (specific form of CK) is elevated will help
determine which tissue has been damaged.
CK can be measured as the total enzyme in the serum, or each of its three
isoenzymes may be measured.
The isoenzymes include:
CK1 (CPK-BB): produced primarily by brain tissue and smooth muscle of the
lungs
CK2 (CPK-MB): produced primarily by heart tissue
CK3 (CPK-MM): produced primarily by skeletal muscle
Normal Values
Total CK
Female: 40150 U/L (0.672.50 kat/L SI units)
Male: 38174 U/L (0.632.90 kat/L SI units)
Isoenzymes
CK1 (CPK-BB): 01%
CK2 (CPK-MB): <3%
CK3 (CPK-MM): 95100%