Chapter 4: Learning Lab Values & Drug Monitoring Flashcards
What can cause agranulocytosis
Clozapine, PTU, methimazole, procainamide, carbamazepine, Bactrim, and isoniazid
What causes increased calcium levels
Calcium supplementation, Vitamin D, thiazide diuretics
What causes decreased calcium levels
long-term heparin, loop diuretics, bisphosphonates, cinacalcet
What causes decreased magnesium levels
PPIs, diuretics
What causes increased phosphate levels
Renal failure
What causes increased K levels
ACEi, ARBs, ARAs, aliskiren, canagliflozin, cyclosporine, tacrolimus, K supplements, SMX/TMP, drosperinone-containing contraceptives
What causes decreased K levels
steroids, B-2 agonsts, diuretics, insulin
What causes decreased Na levels
carbamazepine, oxcarbazepine, SSRIs, diuretics
What causes decreased bicarbonate levels
Topiramate
What causes increased BUN levels
Renal impairment and dehydration
What causes increased SCr
Aminoglycosides, amphotericin B, cisplatin, colistimethane, cyclosporine, loop diuretics, polymyxin, NSAIDs, radiocontrast dye, tacrolimus, vancomycin
Increased anion gap suggests:
metabolic acidosis
What causes increased mean corpuscular volume (MCV)
B12 or folate deficiency
What causes decreased mean corpuscular volume (MCV)
iron deficiency
Folic acid is decreased due to
Phenytoin/phosphenytoin, phenobarbital, primidone, methotrexate, SMX/TMP
Vitamin B12 is decreased due to
PPIs, metformin
When is reticulocyte count decreased
In untreated anemia due to iron, folate or B12 deficiency and with bone marrow suppression
Coombs test is positive in
drug-induced hemolysis caused by PCNs and cephalosporins, dapsone, isoniazid, levodopa, methyldopa, methylene blue, nitrofurantoin, pegloticase, primaquine, quinidine, quinine, rasburicase, rifampin, and sulfonamides
The RBC destruction with G6PD deficiency is triggered by:
Stress, foods (fava beans), dapsone, methylene blue, nitrofurantoin, pegloticase, primaquine, rasburicase, sulfonamides
Anti-Xa peak should be obtained ___ hours after SC LMWH dose
4 hours
What is Anti-Xa used to monitor
LMWH and UFH
PT/INR is used to monitor
warfarin
INR increases (without warfarin) due to
liver disease
False increase in INR occurs from
daptomycin, oritavancin, telavancin
aPTT or PTT is used to monitor
UFH and direct thrombin inhibitors
False increase in aPTT occurs from
oritavancin and televancin
Platelets decrease due to
Heparin, LMWHs, fondaparinux, linezolid, valproic acid
Which drugs are impacted by low albumin
Warfarin, calcium and phenytoin
Which drugs require correction for low albumin
calcium, phenytoin and valproic acid
Amylase and lipase increase in pancreatitis, which can be caused by
didanosine, GLP-1 agonists, DPP-4 inhibitors, valproic acid, hypertriglyceridemia
Creatine Kinase (CK or CPK) is increased due to
daptomycin, statins, tenofovir, raltegravir, dolutegravir
What are the cardiac enzymes that are used in the diagnosis of MI
Troponin T, Troponin I, BNP and NT-proBNP
BNP and NT-proBNP are markers of
Cardiac stress. Higher values indicate higher likelihood of HF
Increased TSH (hypothyroidism) is due to
Tyrosine kinase inhibitors, lithium, carbamazepine
Lactic acid can be increased due to
NRTIs and metformin
Prolactin can increase due to
haloperidol, risperidone, and paliperidone
Uric acid can be increased due to
diuretics, niacin, low doses of ASA, pyrazinamide, cyclosporine, tacrolimus, select pancreatic enzyme products, select chemotherapy (TLS)
Causes of DILE
anti-TNF agents, hydralazine, isoniazid, methimazole, methyldopa, minocycline, procainamide, PTU, quinidine, terbinafine
Which lab parameters are used to assess HIV and monitor treatment
CD4+ lymphocyte count and viral load
What is the antibiody test used to screen for syphilis
RPR
Those with TPMT deficiency may require lower doses of
azathiopurine and mercaptopurine
Therapeutic drug level for vanco
Trough: 15-20 mcg/mL for most serious infections (pneumonia, endocarditis, osteomyelitis, meningitis, and bacteremia)
Trough: 10-15 mcg/mL for others
