Learning Lab Values and Drug Monitoring Flashcards
Leukocytosis
increase WBC
Thrombocytosis
increase PLT
Thrombocytopenia
decrease PLT
Leukopenia
decrease WBC
myelosuppresion
decrease in WBC, RBC, PLT (multiple blood cell lines)
agranulocytosis
decrease in granulocytes (WBCs that secretory granules in the cytoplasm); includes decrease in neutrophils, basophils, eosinophils
Ca levels***
Ca total: 8.5-10.5, ionized is 4.5-5.1. Calculate corrected Ca (only for total Ca, not ionized Ca) if albumin is low (normal albumin levels are 3.5-5)
Drugs that increase Ca levels
vitamin D, thiazides
Drugs that decrease Ca levels
systemic steroids, long-term heparin, cinacalcet (used to treat high levels of Ca), loop diuretics, bisphosphonates
Drugs that lower Mg levels
PPIs, diuretics
Increased phosphate levels = ?
renal failure
Drugs that increase K levels***
3.5-5 is normal. RAAS drugs, canagliflozin, cyclosporine, tacrolimus, K supplements, bactrim, drosperinone-containing OCs
Drugs that lower sodium
carbamazepine, oxcarbazepine, SSIs, diuretics
Drugs that increase bicarb
loop diuretics, systemic steroids
Drugs that decrease bicarb
topiramate
Why we check bicarb
acid base status
Increased BUN = ?
renal impairment, dehydration (BUN:Cr ratio > 20:1)
Drugs that increase Scr***
drugs that impair renal function (AGs, amphotericin B, cisplatin, colistimethate, cyclosporine, loop diuretics, polymyxin, NSAIDs, radiocontrast dye, tacrolimus, vancomycin)
False increase d/t cobicistat, bactrim, H2RAs
What causes decrease in Scr
low muscle mass, amputation, hemodilation
Why do we check AG
high anion gap suggests metabolic acidosis
WBC increase d/t
systemic steroids
WBC decrease d/t
clozapine, chemo drugs, carbamazepine (not oxcarb), immunosuppressants
eosinophil increase
parasitic infection
basophil increase
hypersensitivity reaction
lymphocyte increase
viral infections, lymphoma
lymphocyte decrease
bone marrow suppression, HIV, systemic steroids
MCV increase
macrocytic anemia- B12 def, folate def
MCV decrease
microcytic anemia- iron def
folic acid decrease d/t
phenytoin/fosphenytoin, phenobarbital, primidone, MTX, bactrim
vit b12 decrease
PPIs, metformin
Coombs Test positive = ? **
drug-induced hemolysis caused by: [[penicillins, cephalosporins, (prolonged use/high concentrations), nitrofurantoin, sulfonamides]], [[dapsone, isoniazid, primaquine, quinidine, quinine, rifampin]], [[levadopa, methyldopa]], methylene blue, pegloticase, rasbiuricase
G6PD
Deficiency caused by- fava beans, dapsone, methylene blue, nitrofurantoin, pegloticase, rasbiuricase, sulfonamides
anti factor Xa
LMWH and UFH
aPTT
UFH
PLT decrease d/t
linezolid, VPA, heparin (HIT), LMWHs (enoxa, dalta, tinze), fondaparinux
Albumin - highly protein bound drugs
warfarin, PHE, Ca
Drugs that require Ca correction when albumin is low
alb < 3.5; PHE, VPA and calculate corrected Ca
increased CK d/t
statins, tenofovir, raltegravir, dolutagrevir, daptomycin
CK levels indicate
myositis, muscle damage, cardiac conditions
C peptide
to distinguish t1dm vs t2dm, evaluates beta cell function. A C-peptide test is often used to help tell the difference between type 1 and type 2 diabetes. With type 1 diabetes, your pancreas makes little to no insulin, and little or no C-peptide. With type 2 diabetes, the body makes insulin, but doesn’t use it well. T1 < ? and T2 0.5-2??? verify in book
Uric acid increase d/t ***
diuretics, niacin, low dose ASA, pyrazinamide, cyclosporine, tacrolimus
DILE can be caused by ? ***
many, but most likely: anti-TNF agents, hydralazine, isoniazid, MMI, methyldopa, minocycline, procainamide, PTU, quinidine, terbinafine
