Learning Lab Values & Drug Monitoring Flashcards
List three drugs that can increase calcium
- calcium supplementation
- vitamin D
- thiazide diuretics
List eight drugs that can decrease calcium
- systemic steroids
- long-term heparin
- loop-diuretics
- bisphosphonates
- cinacalcet
- calcitonin
- foscarnet
- topiramate
List two drugs that can increase magnesium
- magnesium containing antacids
2. magnesium containing laxatives
List five drugs + 2 conditions that can decrease magnesium
- PPI
- diuretics
- amphotericin
- foscarnet
- echinocandins
- diarrhea
- chronic alcohol intake
List three drugs that can decrease phosphate
- phosphate binders
- foscarnet
- oral calcium intake
List thirteen drugs that can increase potassium
- ACE/ARB
- aldosterone receptor antagonists
- aliskiren
- NSAIDs
- cyclosporine
- tacrolimus
- mycophenolate
- potassium supplements
- drosperinone-containing oral contraceptives
- bactrim
- chronic heparin use
- canagliflozin
- pentamidine
List six drugs that can decrease potassium
- steroids
- beta-2 agonists
- conivaptan
- diuretics
- insulin
- mycophenolate (both increase and decrease reported)
List three drugs that can increase sodium
- hypertonic saline
- conivaptan
- tolvaptan
List five drugs that can decrease sodium
- carbamazepine
- oxcarbazepine
- SSRIs
- diuretics
- desmopressin
List three drugs that can increase bicarbonate
- loop diuretics
- systemic steroids
- sodium acetate
List three drugs that can decrease bicarbonate
- topiramate
- zonisamide
- salicylate overdose
List two drugs that can cause false elevations of serum creatinine
- Bactrim
2. H2RAs
List eleven drugs that can cause true elevations of serum creatinine
- aminoglycosides
- amphotericin B
- cisplatin
- colistimethate
- cyclosporine
- loop diuretics
- polymyxin
- NSAIDs
- radiocontrast dye
- tacrolimus
- vancomycin
List three conditions that can cause decrease in serum creatinine (e.g. falsely reflect kidney function)
- low muscle mass
- amputation
- hemodilution
List three drugs that can increase WBC
- systemic steroids
- colony stimulating factors
- epinephrine
List seven drugs that can decrease WBC
- clozapine
- chemotherapy that targets bone marrow
- carbamazepine
- cephalosporins
- immunosuppressants (DMARDs, biologics, etc.)
- procainamide
- vancomycin
List four conditions that can increase eosinophils
- drug allergy
- asthma
- inflammation
- parasitic infection
List three conditions that can increase basophils
- inflammation
- hypersensitivity reaction
- leukemia
List two conditions that can increase lymphocytes
- viral infections
2. lymphoma
List two conditions + 1 drug that can decrease lymphocytes
- bone marrow suppression
- HIV
- systemic steroids
List three conditions that can increase monocytes
- chronic infections
- inflammation
- stress
List 2 drugs + 1 condition that can increase RBC
- erythropoiesis-stimulating agents (ESA)
- smoking
- polycythemia
List six conditions that can decrease RBC
- chemotherapy that targets bone marrow
- low production
- blood loss
- deficiency anemias (B12, folate)
- hemolytic anemia
- sickle cell anemia
List one drug that can increase Hgb/Hct
- erythropoiesis-stimulating-agents
List two drugs/conditions that can decrease Hgb/Hct
- anemias
2. bleeding (anticoagulants, antiplatelets, P2Y12 inhibitors, fibrinolytics)
List two conditions that can increase mean corpuscular volume (MCV)
- B12 deficiency
2. folate deficiency
List one condition that can decrease mean corpuscular volume (MCV)
- iron deficiency
List one drug that can increase Iron levels
- iron supplementation
List two conditions that can decrease iron levels
- blood loss
2. poor nutritional intake
List six drugs that can decrease folic acid
- phenytoin/fosphenytoin
- phenobarbital
- primidone
- methotrexate
- sulfasalazine
- sulfamethoxazole/trimethoprim
List four drugs that can decrease Vitamin B12 levels
- PPI
- metformin
- colchicine
- chloramphenicol
List ten drugs that can result in a positive Coombs test (also known as Direct Antiglobulin Test [DAT])
- penicillins
- cephalosporins
- isoniazid
- levodopa
- methyldopa
- nitrofurantoin
- quinidine
- quinine
- rifampin
- sulfonamides
List twelve drugs that can result in hemolytic anemia due to Glucose-6-phosphate dehydrogenase deficiency (G6PD)
- stress
- fava beans
- chloroquine
- dapsone
- methylene blue
- nitrofurantoin
- primaquine
- probenecid
- quinidine
- quinine
- rasburicase
- sulfonamides
When should a antifactor Xa activity (Anti-Xa) be drawn
4 hours after SC LMWH dose
List six conditions which might warrant Anti-Xa monitoring
- pregnancy
- obesity
- low body weight
- pediatrics
- elderly
- renal insufficiency
List three drugs which can increase anti-Xa levels
- heparin
- LMWH
- fondaparinux
List three drugs which falsely elevate INR
- daptomycin
- oritavancin
- telavancin
List seven drugs which decrease platelets
- heparin
- LMWH
- fondaparinux
- glycoprotein IIb/IIIa receptor antagonists (ReoPro, Integrilin, Aggrastat)
- linezolid
- valproic acid
- chemotherapy that targets bone marrow
List two tests used to diagnose Heparin-induced thrombocytopenia (HIT)
- First ELISA test, then if positive,
2. a Serotonin release assay (SRA) is confirmatory.
List two conditions that can decrease albumin
- cirrhosis
2. malnutrition
List three drugs/levels which require correction for low albumin
- phenytoin
- valproic acid
- calcium
List two drugs which can increase ammonia
- valproic acid
2. topiramate
List one drug which can decrease ammonia
- lactulose
List four drugs and one condition which can cause elevations in amylase/lipase (e.g. pancreatitis markers)
- didanosine
- stavudine
- GLP-1 agonists
- valproic acid
- hypertriglyceridemia
List nine drugs which can increase Creatinine Kinase
- daptomycin
- quinupristin/dalfopristin
- statins
- fibrates
- emtricitabine
- tenofovir
- tipranavir
- raltegravir
- dolutegravir
Fasting begins x hours prior to lipid blood draw
9-12 hours
Fasting begins x hours prior to Fasting Plasma Glucose
8+ hours
List two drugs which can increase or decrease Thyroid Stimulating Hormone (TSH)
- amiodarone
2. interferons
List four drugs which can increase thyroid stimulating hormone (TSH)
- interferons
- tyrosine kinase inhibitors
- lithium
- carbamazepine
List eight drugs which can elevate uric acid
- diuretics
- niacin
- high doses of aspirin
- pyrazinamide
- cyclosporine
- tacrolimus
- select pancreatic enzyme products
- chemotherapy (tumor lysis syndrome)
List ten drugs which can cause Drug-induced lupus erythematosus (DILE)
- anti-TNF agents
- hydralazine
- isoniazid
- methimazole
- methyldopa
- minocycline
- procainamide
- propylthiouracil
- quinidine
- terbinafine
List three tests which can help establish diagnosis of drug-induced lupus erythematosus
- Antinuclear antibodies (ANA)
- Histone antibody (detected by ELISA)
- anti-dsDNA
List two lab values that can increase with testosterone supplementation
- total free testosterone
2. prostate-specific antigent (PSA)
What lab value is tested to determine pregnancy?
Human Chorionic Gonadotropin (hCG)
List four drugs which can increase lactic acid
- NRTIs
- metformin
- alcohol
- cyanide
List four drugs which can increase prolactin
- haloperidol
- risperidone
- paliperidone
- methyldopine
List one drug which can decrease prolactin
Bromocriptine
What test is used to screen for syphilis?
- Rapid Plasma Reagin
List four drugs which can increase serum osmolality
- mannitol
- ethylene glycol
- methanol
- propylene glycol
List two drugs which may require lower doses in patients with genetic deficiency of Thiopurine Methyltransferase (TPMT)
- azathioprine
2. mercaptopurine
TDM level of carbamazepine
4-12 mcg/mL
TDM level of digoxin for Afib
0.8-2 ng/mL
TDM level of digoxin for HF
0.5-0.9 ng/mL
TDM of gentamicin, peak
5-10 mcg/mL
TDM of gentamicin, trough
<2 mcg/mL
TDM of lithium, acute symptoms
1.5 mEq/L
TDM of lithium, maintenance
0.6-1.2 mEq/L
TDM of phenytoin/fosphenytoin
10-20 mcg/mL
TDM of free phenytoin
1-2.5 mcg/mL
TDM of N-acetylprocainamide (NAPA)
15-25 mcg/mL
TDM of procainamide
4-10 mcg/mL
TDM of combined NAPA and procainamide
10-30 mcg/mL
TDM of theophylline
5-15 mcg/mL
TDM of tobramycin, peak
5-10 mcg/mL
TDM of tobramycin, tourhg
<2 mcg/mL
TDM of valproic acid
50-100 mcg/mL (up to 150 mcg/mL in some patients)
TDM of vancomycin, non-severe infection, trough
10-15 mcg/mL
TDM of vancomycin, severe infection, trough
15-20 mcg/mL
TDM of warfarin, most indications
INR 2-3
TDM of warfarin, mechanical mitral valve
INR 2.5-3.5