Lab Values and Monitoring Flashcards
normal total calcium
8.5-10.5 mg/dL
increases calcium (2)
- vitamin D
- thiazide diuretics
decreases calcium (4)
- long-term heparin
- loop diuretics
- bisphosphonates
- cinacalcet
normal magnesium
1.3 - 2.1 mEq/L
decreases magnesium (3)
- PPIs
- diuretics
- amphotericin B
normal phosphate
2.3 - 4.7 mg/dL
increased phosphate (1)
CKD
normal potassium
3.5 - 5 mEq/L
increases potassium (9)
- ACE/ARB
- aldosterone receptor antagonists
- aliskiren
- canagliflozin
- cyclosporine
- tacrolimus
- potassium supplements
- Bactrim
- drospirenone-containing oral contraceptives
decreases potassium (3)
- beta 2 agonists
- diuretics
- insulin
normal sodium
135-145 mEq/L
increases sodium (2)
- hypertonic saline
- tolvaptan
decreases sodium
- carbamazepine
- oxcarbamazepine
- SSRIs
- diuretics
normal bicarbonate
Venous: 24-30 mEq/L
Arterial: 22-26 mEq/L
decreases bicarbonate (1)
topiramate
normal BUN
7-20 mg/dL
increases BUN (2)
renal impairment and dehydration
normal serum creatinine
0.6-1.3 mg/dL
increases SCr (11)
- aminoglycosides
- amphotericin B
- cisplatin
- colistimethate
- cyclosporine
- loop diuretics
- polymyxin
- NSAIDs
- radiocontrast dye
- tacrolimus
- vancomycin
normal anion gap
5-12 mEq/L
normal WBC
4,000-11,000 cells/mm3
increases WBC (1)
systemic steroids
decreases WBC (4)
- clozapine
- chemotherapy
- carbamazepine
- immunosuppressants
normal neutrophils
45-73%
normal bands
3-5%
normal eosinophils
0-5%
increases eosinophils (3)
- asthma
- inflammation
- parasitic infection
normal basophils
0-1%
increases basophils (1)
hypersensitivity reactions
normal lymphocytes
20-40%
increases lymphocytes (2)
viral infections
lymphoma
decreases lymphocytes (3)
- bone marrow suppression
- HIV
- systemic steroids
normal RBCs
Males: 4.5-5.5
Females: 4.1-4.9
increases RBCs (1)
ESAs
decreases RBCs (4)
- chemo
- deficiency anemias (B12, folate)
- hemolytic anemia
- sickle cell anemia
normal Hgb
males: 13.5-18 g/dL
females: 12-16 g/dL
normal MCV
80-100 fL
increased MCV
macrocyctic anemia (B12 or folate deficiency)
decreased MCV
microcytic anemia (iron deficiency)
normal folic acid (folate)
5-25 mcg/L
decreases folic acid (5)
- phenytoin/fosphenytoin
- phenobarbital
- primidone
-methotrexate - Bactrim
normal vitamin B12
> 200 pg/mL
decreases vitamin B12 (2)
- PPIs
- metformin
normal reticulocyte count
0.5-2.5%
decreased reticulocyte count (2)
- untreated anemia
- bone marrow suppression
drugs that can cause hemolytic anemia identified by a positive Coombs test (14)
- penicillins and cephalosporins
- dapsone
- isoniazid
- levodopa
- methyldopa
- methylene blue
- nitrofurantoin
- pegloticase
- primaquine
- quinidine
- quinine
- rasburicase
- rifampin
- sulfonamides
normal G6PD
5-14 units/g
Drugs that cause RBC destruction with G6PD deficiency (7)
- dapsone
- methylene blue
- nitrofurantoin
- pegloticase
- primaquine
- rasburicase
- sulfonamides
normal platelets
150,000 - 450,000 cells/mm3
decreases platelets (5)
- heparin
- LMWHs
- fondaparinux
- linezolid
- valproic acid
normal albumin
3.5-5 g/dL
decreases albumin (2)
- cirrhosis
- malnutrition
normal total bilirubin
0.1-1.2 mg/dL
ammonia is often measured in what?
suspected hepatic encephalopathy
increases ammonia (2)
- valproic acid
- topiramate
decreases ammonia (1)
lactulose
normal amylase
60-180 units/L
normal lipase
5-160 units/L
things that cause pancreatitis (increased amylase/lipase) (5)
- didanosine
- GLP-1 agonists
- DPP-4 inhibitors
- valproic acid
- hypertriglyceridemia
normal CPK
males: 55-170 IU/L
females: 30-135 IU/L
increases CPK (5)
- daptomycin
- statins
- tenofovir
- raltegravir
- dolutegravir
normal troponin T
normal troponin I
0-0.1 ng/mL
0-0.5 ng/mL
normal BNP
< 100 pg/mL or ng/L
normal NT-proBNP
males: < 61 pg/mL
females: 12-151 pg/mL
normal LDL
< 100 mg/dL
normal HDL
> /= 60
normal TGs
< 150 mg/dL
normal CRP
0-0.5 mg/dL
normal TSH
0.3-3 mIU/L
drugs that increase or decrease TSH (2)
- amiodarone
- interferons
drugs that increase TSH (hypothyroidism) (3)
- tyrosine kinase inhibitors
- lithium
- carbamazepine
normal uric acid
males: 3.5-7.2 mg/dL
females: 2-6.5 mg/dL
increases uric acid (8)
- diuretics
- niacin
- low doses of aspirin
- pyrazinamide
- cyclosporine
- tacrolimus
- select pancreatic enzyme products
- select chemotherapy
normal ESR
males: 20 mm/hr or lower
females: 30 mm/hr or lower
drugs that cause DILE (10)
- anti-TNF agents
- hydralazine
- isoniazid
- methimazole
- methyldopa
- minocycline
- procainamide
- propylthiouracil
- quinidine
- terbinafine
normal pH
7.35-7.45
normal prostate-specific antigen (PSA)
< 4 ng/mL
normal lactic acid (lactate)
0.5-2.2 mEq/L
increases lactic acid (2)
- NRTIs
- metformin
drugs that increase prolactin (3)
- haloperidol
- risperidone
- paliperidone
normal thiopurine methyltransferase (TPMT)
15 units/mL or higher
Those with TPMT deficiency are at increased risk for myelosuppression and may need lower doses of which drugs (2)?
- azathioprine
- mercaptopurine
normal vitamin D (25(OH))
> 30 ng/mL
carbamazepine therapeutic range
4-12 mcg/mL
digoxin therapeutic range (2)
afib: 0.8-2 ng/mL
HF: 0.5-0.9 ng/mL
gentamicin trough and peak ranges (traditional dosing)
peak: 5-10 mcg/mL
trough: < 2 mcg/mL
lithium therapeutic range
0.6-1.2 mEq/L (up to 1.5 mEq/L for acute symptoms)
phenytoin/fosphenytoin therapeutic range
10-20 mcg/mL
free phenytoin therapeutic range
1-2.5 mcg/mL
procainamide therapeutic range
4-10 mcg/mL
NAPA (procainamide active metabolite) therapeutic range
15-25 mcg/mL
NAPA + procainamide therapeutic range
10-30 mcg/mL
theophylline therapeutic range
5-15 mcg/mL
tobramycin peak and trough (traditional dosing)
peak: 5-10 mcg/mL
trough: < 2 mcg/mL
valproic acid therapeutic range
50-100 mcg/mL (up to 150 mcg/mL in some patients)
vancomycin troughs
serious infections: 15-20 mcg/mL
others: 10-15 mcg/mL
warfarin INR goals
2-3
2.5-3.5 in patients with mechanical mitral valves