Ch 17: Lab Values and Drug Monitoring

Question 1

BMP (basic metabolic panel)

Answer 1

lytes and glucose, acid/base, renal fxn.

Question 2

CMP (comprehensive metabolic panel)

Answer 2

BMP + alb, ALT/AST, total bilirubin nd total protein (aka for liver fxn)

Question 3

plt life span

Answer 3

7-10 days

Question 4

Coombs test, direct aka direct antiglobulin test (DAT)

Answer 4

used to determine cause of hemolytic anemia (autoimmune vs drug induced) (+) in drug-induced hemolysis caused by pcns, cephs, isoniazid, levodopa, methyldopa, macrobid, quinidine, quinine, rifampin, and sulfonamides. DC offending drug

Question 5

glucose 6 phosphate dehydrogenase (g6pd)

Answer 5

used to determine if hemolytic anemia is d/t g6pd deficiency. triggers: stress, foods (fava beans) or drugs - chloroquine, dapsone, methylene blue, macrobid, primaquine, probenecid, quinidine, quinine, rasburicase, and sulfonamides

Question 6

anti Xa activity

Answer 6

obtain pk 4 h after LMWH dose. monitor in preg for heparin and LMWH.

Question 7

TDM amikacin traditional dosing

Answer 7

pk: 20-30 mcg/ml. tr: <5 mcg/ml

Question 8

TDM carbamazepine

Answer 8

4-12 mcg/ml

Question 9

TDM digoxin

Answer 9

0.8-2 ng/ml AF (higher). 0.5-0.9 ng/ml HF.

Question 10

TDM gentamicin traditional dosing

Answer 10

pk: 5-10 mcg/ml. tr: <2 mcg/ml

Question 11

TDM lithium

Answer 11

0.6-1.2 mEq/L (up to 1.5 for acute sx)

Question 12

TDM enoxaparin

Answer 12

VTE tx QD: 1-2 anti-Xa units/ml. VTE tx BID: 0.6-1 anti-Xaa units/ml. recurrent VTE ppx in preg: 0.2-0.6 anti-Xa units/ml.

Question 13

TDM phenobarbital/primidone

Answer 13

20-40 mcg/ml

Question 14

TDM pheytoin/fosphenytoin

Answer 14

10-20 mcg/ml - if alb low then correct. free phenytoin: 1-2.5 mcg/ml.

Question 15

TDM procainamide, NAPA, combined

Answer 15

procainamide: 4-10 mcg/ml. NAPA 15-35 mcg/ml. combined 10-30 mcg/ml.

Question 16

TDM theophylline

Answer 16

5-15 mcg/ml. 5-10 for neonates

Question 17

TDM tobramycin traditional dosing

Answer 17

pk: 5-10 mcg/ml/ tr: <2 mcg/ml

Question 18

TDM valproic acid

Answer 18

50-100 mcg/ml (up to 150 in some pts). if alb low, correct it.

Question 19

TDM vancomycin

Answer 19

15-20 mcg/ml mostly. 10-15 for UTI or simple SSTI

Question 20

TDM warfarin

Answer 20

goal is 2-3 INR for most. 2.5-3.5 for mech mitral valves.