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NAPLEX Review UWorld > Ch 4: Lab Values & Drug Monitoring > Flashcards

Ch 4: Lab Values & Drug Monitoring Flashcards

1
Q

Drugs that causes Agranulocytosis

When the absolute neutrophil count (ANC) < 100 neutrophils/microliters

A

Clozapine
Propylthiouracil
Methimazole
Procainamide
Carbamazepine
Ioniazid
Bactrim

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2
Q

Drugs that ↑ Ca

A

Vit D
Thiazides

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3
Q

Drugs that ↓ Ca

A

Long-term heparin
Loop diuretics
Biphosphonates
Cinacalcet
Systemic steroids
Calcitonin
Foscarnet
Topiramate

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4
Q

Drugs that ↓ Mg

A

PPls,
diuretics,
amphotericin B,
foscarnet,
echinocandins,
diarrhea,
chronic alcohol intake

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5
Q

What condition causes ↑ in PO4?

A

Chronic Kidney Disease

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6
Q

Drugs that ↑ K

A

ACE inhibitors,
ARBs,
aldosterone receptor antagonists (ARAs),
aliskiren,
canagliflozin,
cyclosporine,
tacrolimus,
mycophenolate,
potassium supplements,
sulfamethoxazole/trimethoprim,
drospirenone-containing oral contraceptives,
chronic heparin use,
NSAIDs,
pentamidine .

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7
Q

Drugs that ↓ K

A

beta-2 agonists,
diuretics,
insulin,
sodium polystyrene sulfonate
steroids,
conivaptan,
mycophenolate (both ↑ and ↓ reported)

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8
Q

Drugs that ↑ Na

A

hypertonic saline,
tolvaptan,
conivaptan.

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9
Q

Drugs that ↓ Na

A

carbamazepine,
oxcarbazepine,
SSRls,
diuretics,
desmopressin

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10
Q

Drugs that ↓ HCO3

A

topiramate,
zonisamide,
salicylate overdose

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11
Q

What conditions cause an ↑ BUN?

A

renal impairment
dehydration

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12
Q

Drugs that ↑ SCr

A

aminoglycosides,
amphotericin B,
cisplatin,
colistimethate,
cyclosporine,
loop diuretics,
polymyxin,
NSAIDs,
radiocontrast dye,
tacrolimus, vancomycin

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13
Q

↑ Anion Gap suggest _

A

metabolic acidosis

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14
Q

Drugs that ↑ WBCs

A

Systemic steroids
Colony stimulating factors
epinephrine

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15
Q

Drugs that ↓ WBCs

A

clozapine,
chemotherapy that targets the bone marrow,
carbamazepine,
cephalosporins,
immunosuppressants (e.g., DMARDs, biologics)
procainamide,
vancomycin.

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16
Q

What conditions cause an ↑ eosinophils?

A

drug allergy,
asthma,
inflammation,
parasitic infection.

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17
Q

What conditions cause an ↑ Basophils?

A

inflammation,
hypersensitivity reaction,
leukemia

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18
Q

What conditions cause an ↑ lymphocytes?

A

viral infections,
lymphoma

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19
Q

What conditions cause an ↓ lymphocytes?

A

bone marrow suppression,
HIV or due to systemic steroids

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20
Q

RBCs lifespan

A

120 days

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21
Q

What conditions cause an ↑ RBCs?

A

erythropoiesis-stimulating agents (ESAs),
smoking
polycythemia (a condition that causes high RBCs

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22
Q

What conditions cause ↓ RBCs?

A

chemotherapy that targets the bone marrow,
low production,
blood loss,
deficiency anemias (e.g., B12, folate),
hemolytic anemia,
sickle cell anemia.

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23
Q

What causes an ↑ Hgb?

A

ESAs

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24
Q

What causes a ↓ Hgb?

A

Anemias
Bleeding

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25
Q

What causes an ↑ MCV?

A

B12 or folate deficiency

Macrocytic anemia

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26
Q

What causes a ↓ MCV?

A

Iron deficiency

Microcytic anemia

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27
Q

Drugs that ↓ folic acid

A

phenytoin/fosphenytoin,
phenobarbital,
primidone,
methotrexate,
sulfamethoxazole/trimethoprim,
sulfasalazine

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28
Q

Drugs that ↓ B12

A

PPIs
Metformin
Colchicine
Chloramphenicol

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29
Q

What conditions cause ↓ reticulocyte count?

A

untreated anemia due to iron, folate or B12 deficiency
bone marrow suppression

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30
Q

Coombs Test, Direct

A

Used in the diagnosis of immune-mediated hemolytic anemia

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31
Q

Drugs that can cause immune-mediated hemolytic anemia

A

penicillins and cephalosporins (prolonged use/high concentrations),
isoniazid,
levodopa,
methyldopa,
quinidine,
quinine,
rasburicase
rifampin
sulfonamides.

If positive D/C drug

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32
Q

G6PD deficiency is triggered by what drugs

A

dapsone,
methylene blue,
nitrofurantoin,
pegloticase,
primaquine,
rasburicase,
sulfonamides

Also by stress or foods (fava beans)

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33
Q

Anti-Factor Xa Activity

When to obtain labs for LMWH?

A

Obtain a peak anti-Xa level 4 hours after a SC dose

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34
Q

Anti-Factor Xa Activity

When to obtain labs for unfractionated heparin?

A

Obtain anti-Xa level 6 hours after IV infusion starts & Q6H until therapeutic

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35
Q

What ↑ INR w/out taking warfarin?

A

Liver disease

36
Q

What can falsely ↑ INR?

A

daptomycin
ortavancin
telavancin

37
Q

What can falsely ↑ aPTT?

A

Oritavancin
Telavancin

38
Q

aPTT therapeutic range

A

1.5-2.5 x the control range

control range depends on instituton

39
Q

What is the average life span of platelets (PLTs)?

A

7-10 days

40
Q

Drugs that ↑ platelets

A

heparin,
LMWHs,
fondaparinux,
glycoprotein lib/Illa receptor antagonists,
linezolid,
valproic acid,
chemotherapy that targets the bone marrow

41
Q

Heparin-induce thrombocytopenia (HIT) is when?

A

Platelets drop > 50%

ELISA test 1st, then serotonin release assay (SRA) is confirmatory

42
Q

Albumin ↓ due to?

A

cirrhosis & malnutrition

43
Q

What drugs are impacted by low albumin?

A

warfarin
calcium
phenytoin

44
Q

What drugs require correction for low albumin?

A

phenytoin
calcium

45
Q

What enzymes are released from injured hepatocytes?

A

AST & ALT

46
Q

Bilirubin, total (Tbili) is use to?

A

determine liver damage & detect bile duct blockage

47
Q

Ammonia is measure when _ is suspected

A

hepatic encephalopathy (HE)

48
Q

Drugs that ↑ ammonia

A

valproic acid
topiramate

49
Q

Drugs that ↓ ammonia

A

lactulose

50
Q

What condition can cause ↑ in amylase & lipase?

A

pancreatitis

51
Q

Drugs that ↑ amylase & lipase

A

didanosine,
stavudine,
GLP-1 agonists,
DPP-4 inhibitors,
valproic acid,
hypertriglyceridemia.

52
Q

Creatine Kinase (CK) is use to?

or Creatine Phosphokinase (CPK)

A

assess muscle inflammation (myositis) or muscle damage

Also to DX cardiac conditions

53
Q

Drugs that ↑ Creatine Kinase (CK)

A

daptomycin,
quinupristin/dalfopristin,
statins,
fibrates (especially if given with a statin),
emtricitabine,
tenofovir,
tipranavir,
raltegravir,
dolutegravir

54
Q

Troponin is use to?

T & I

A

DX MI

55
Q

B-Type Natriuretic Peptide (BNP) is?

also N-Terminal-ProBNP (NT-proBNP)

A

marker of cardiac stress

↑ BNP w/ HF symptoms indicate a higher lkelihood of HF

56
Q

LDL normal range

A

< 100 mg/dL

Fasting 9-12 hrs prior to lipid blood draw

57
Q

Non-HDL normal range

A

< 130 mg/dL

58
Q

↑ C-reactive Protein indicates (CRP)

A

inflammation

59
Q

Fasting Plasma Glucose (FPG) range

A

Diabetes: ≥ 126 mg/dL
Prediabetes: 100-125 mg/dL

Begin fasting ≥ 8 hrs prior to blood draw

60
Q

Hemoglobin A1C range

A

< 7%

Average blood glucose over the past 3 months

Per ADA

61
Q

Estimated Average Flucose (eAG) range

A

< 154 mg/dL

Per ADA

62
Q

eAG of _ mg/dL = A1C of _ %

A

126 = 6%

63
Q

Preprandial BG range

A

80-130 mg/dL

Per ADA

64
Q

Postprandial BG range

A

< 180 mg/dL

Per ADA

65
Q

C-Peptide is use to?

A

distinguishe between type 1 & 2 diabetes

↓ or absent → type 1

66
Q

Drugs that ↑ or ↓ TSH

A

amiodarone
interferons

67
Q

Drugs that ↑ TSH

A

tyrosine kinase inhibitors
lithium
carbamazepine

68
Q

Drugs that ↑ uric acid

A

Aspirin (low doses)
B3 (niacin)
Cyclosporin & tacrolimus
Chemotherapy (select, due to tumor lysis syndrome)
Diuretics (Loops & thiazides)
Ethambutol & pyrazinamide (TB meds)
Enzyme (select pancreatic enzyme products)

69
Q

Drugs that can cause drug-induce lupus erythematosus (DILE)

A

anti-TN F agents,
hydralazine,
isoniazid,
methimazole,
methyldopa,
minocycline,
procainamide,
propylthiouracil,
quinidine,
terbinafine

70
Q

Drugs that ↑ lactic acids

A

NRTls
metformin (low risk/mostly with renal disease and heart failure),
alcohol,
cyanide

71
Q

Drugs that can ↑ prolactin

A

haloperidol,
risperidone,
paliperidone,
methyldopa

72
Q

What the screen for syphilis?

A

Rapid Plasma Reagin (RPR) or
Veneral Diseases Research laboratory (VDRL)

Non-treponemal antibody test

73
Q

What drugs requires ↓ dose when patient has a genetid deficiency of thiopurine methyltransferase (TPMT)?

A

azathiprine
mercaptopurine

74
Q

Therapeutic Range

Carbamazepine

A

4-12 mcg/mL

75
Q

Therapeutic Range

Digoxin

A

AF: 0.8-2 ng/mL

HF: 0.5-0.9 ng/mL

76
Q

Therapeutic Range

Gentamicin/Tobramycin

Traditional Dosing

A

Peak: 5-10 mcg/mL

Trough: < 2 mcg/mL

77
Q

Therapeutic Range

Lithium

A

0.6-1.2 mEq/mL
up to 1.5 mEq/mL for acut symptoms

drawn as a trough

78
Q

Therapeutic Range

Phenytoin/Fosphenytoin

A

10-20 mcg/mL

If albumin is loaw, calculate a corrected level

79
Q

Therapeutic Range

Free Phenytoin

A

1-2.5 mcg/mL

80
Q

Therapeutic Range

Procainamide

A

4-10 mcg/mL

81
Q

Therapeutic Range

NAPA (Procainamide Active Metabolite)

A

15-25 mcg/mL

82
Q

Therapeutic Range

Combined Procainamide

A

10-30 mcg/mL

83
Q

Therapeutic Range

Theophylline

A

5-15 mcg/mL

84
Q

Therapeutic Range

Valproic acid

A

50-100 mcg/mL

up to 150 mcg/mL in some patients

85
Q

Therapeutic Range

Vancomycin

A

15-20 mcg/mL for most serious infections

10-15 mg/mL for others

Trough

Srious infections: pneumonia, endocarditis, steomyelitis, meningitis, bacteremia

86
Q

About how many t1/2 lives to reach steady state.

A

5

87
Q

Brand:Generic

BiDil

A

hydralazine/isosorbide dinitrate

NAPLEX Review UWorld (17 decks)

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