Mark K lecture 6 Flashcards
- Lithium Use
(antimania drug), used for mania in bipolar
Lithium Therpidic level, toxic level, grey area
Therapeutic level: 0.6 to 1.2
* Toxic level: >2.0
* Notice gray area: 1.3 to 2
Lanoxin or Digoxin use
Used to treat A-Fib and CHF
Lanoxin or Digoxin Therpidic level, toxic level, grey are
Therapeutic level: 1 to 2
* Toxic level: >2
Aminophylline use
muscle spasm relaxer for the airway
Aminophylline Therpidic level, toxic level,
- Compound of the bronchodilator theophylline
- Therapeutic level: 10 to 20
- Toxic level: >20
- Non-therapeutic level: <10 … if it is not therapeutic, increase dose of medication, and assess for compliance
Dilantin (phenytoin) use
- Seizure medication
Dilantin (phenytoin) Therpidic level, toxic level,
- Therapeutic level: 10-20
- Toxic level: >20
Bilirubin
*Breakdown product of Red Blood Cells
The normal level for Bili for adults
Normal level in adults: 0.2 to 1.2
Bili levels in newborns
o Elevated level: 10 to 20
o Toxicity: >20
When do physicians want to hospitalize these newborns?
o When bilirubin level is about 14 to 15
Patterns
- 1s and 10s
- 2s and 20s
o 2s: Low # (Lithium and Lanoxin)
o 20s: High # (Aminophylline, Dilantin
and Bilirubin)
Kernicterus
Excess bilirubin in the brain
* Occurs when level in the blood gets >20
* In the brain, it may cause aseptic (sterile) meningitis or encephalopathy (don’t need to know)
* It can be DEADLY
Opisthotonos
- Position the newborn assume due to irritation of the meninges from kernicterus
- Presentation: hyperextended posture … (Is a medical emergency)
In what position do you place an opisthotonic newborn?
- Put newborn on the side
Pathological vs. Physiological Jaundice
- If the newborn comes out yellow, something is wrong = Pathologic jaundice
- If the newborn turn yellow 2 to 3 days postpartum, that’s ok = Physiologic jaundice