How Drugs Affect Electrolyte/Lab Values

Question 1

Increased Calcium levels

Answer 1

May be due to calcium supplementation, vitamin D, thiazide diuretics

Question 2

Low calcium levels

Answer 2

systemic steroids, long term heparin, diuretics, bisphosphonates, cinacalcet, calcitonin, foscarnet, topiramate

Question 3

Increased magnesium levels

Answer 3

magnesium containing antacids and laxatives with renal impairment

Question 4

Decreased magnesium levels

Answer 4

PPIs, diuretics, amphotericin, foscarnet, echinocandins, diarrhea, chronic alcohol intake

Question 5

Increased phosphate levels

Answer 5

Renal failure

Question 6

Decreased phosphate levels

Answer 6

phosphate binders, foscarnet, oral calcium intake

Question 7

Increased potassium levels

Answer 7

ACE inhibiors, ARBs, aldosterone receptor antagonists, aliskiren, canagliflozin, cyclosporine, tacrolimus, mycophenolate, potassium supplements, bactrim, drospirenone containing oral contraceptives, chronic heparin use, NSAIDs, pentamidine

Question 8

decreased potassium levels

Answer 8

steroids, beta 2 agonists, conivaptan, diuretics, insulin

Question 9

Increased sodium levels

Answer 9

hypertonic saline

Question 10

decreased sodium levels

Answer 10

carbamazepine, oxcarbazepine, SSRI, diuretics, desmopressin

Question 11

Increased bicarbonate

Answer 11

loop diuretics, systemic steroids

Question 12

Decreased bicarbonate

Answer 12

topiramate, zonisamide, salicylate overdose

Question 13

Increased BUN

Answer 13

Increased renal impairment and dehydration

Question 14

Increased serum creatinine

Answer 14

Nephrotoxic drugs causing impair renal function such as aminoglycosides, amphotericin B, cisplatin, colistimethate, cyclosporine, loop diuretics, polymixin, NSAIDs, radiocontrast dye, tacrolimus, vancomycin.

False increases may be due to bactrim, H2RAs, and cobicistat

Question 15

Low SCr

Answer 15

low muscle mass, amputation, hemodilution

Question 16

Increased WBC (due to drugs)

Answer 16

systemic steroids, colony stimulating factors, epinephrine

Question 17

Decreased WBC (due to drugs)

Answer 17

clozapine, chemotherapy that targets the bone marrow, carbamazepine, cephalosporins, immunosuppressants, procainamide, vancomycin

Question 18

Decreased folic acid

Answer 18

Phenytoin/fosphenytoin, phenobarbital, primidone, methotrexate, bactrim, sulfasalazine

Question 19

Decreased B12

Answer 19

PPIs, metformin, colchicine, chloraphenicol.

Question 20

Increases in amylase/lipase

Answer 20

pancreatitis, didanosine, stavudine, GLP-1 agonists, DPP4 inhibitors, valproic acid, hypertriglyceridemia

Question 21

Increased creatinine kinase or creatine phosphokinase

Answer 21

daptomycin, statins, fibrates, emtricitabine, tenofovir, tipranavir, raltegravir, dolutegravir

Question 22

Increased uric acid

Answer 22

diuretics, niacin, low dose aspirin, pyrazinamide, cyclosporine, tacrolimus, select chemotherapy (tumor lysis syndrome)

Question 23

Increased lactic acid

Answer 23

NRTIs, metformin, alcohol, cyanide

Question 24

Increased prolactin

Answer 24

haloperidol, risperidone, paliperidone, methyldopa