Drug Toxicity

Question 1

Lithium

Answer 1

antimania, bipolar use but only for the mania not depression

therapeutic: 0.6-1.2
toxic: greater than 2.0

think “L…low; 2 versus 20”

Question 2

Lanoxin

Answer 2

dig; Afib and CHF

therapeutic: 1-2
toxic: greater than 2

think “L…low; 2 versus 20”

Question 3

If you get a level of 2 for Lanoxin, what would you consider it?

Answer 3

toxic, safer to call it toxic than therapeutic

Question 4

Aminophylline

Answer 4

muscle spasm relaxer, spasms of the airway, technically not a bronchodilator

therapeutic: 10-20
toxic: greater than 20

“not an L, not the low one…”

Question 5

If you get a level of less than 10 for aminophylline, what would you conclude?

Answer 5

not therapeutic, need more or are they even taking it?

Question 6

Dilantin

Answer 6

anti-seizure

therapeutic: 10-20
toxic: greater than 20

“not an L, not the low one”

Question 7

Bilirubin

Answer 7

not a drug, waste of the breakdown of RBC

-only tested in newborns for NCLEX

elevated level: 10-20
toxic: greater than 20

Question 8

when do doctors think about hospitalizing these newborns?

Answer 8

when bilirubin is halfway to toxic…14-15

Question 9

Kernicterus

Answer 9

bilirubin in the brain (through BBB)

when bilirubin greater than 20, think its in CSF

-these babies can die

Question 10

Jaundice

Answer 10

bilirubin in the skin

Question 11

Opisthertonus

Answer 11

position of HTN seen in kernicterus

• heals to head bending
• arching of the neck, neck off the bed

Question 12

What do you do when you see your newborn patient in opisthertonus?

Answer 12

place baby on its side

Question 13

physiologic versus pathologic

Answer 13

physiologic: normal at birth…goes up day 2-3 (normal finding)
pathologic: come out yellow, something is wrong