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Clin Lab Med Final > Med management > Flashcards

Med management Flashcards

1
Q

Can cause gingival hypertrophy

morbilliform rash, lethagy, hirsutism, megoblastic anemia

A

Phenytoin/Dilantin

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2
Q

Excessive blood levels of phenytoin >20

*no specific antidote (supportive care, HD and transfusion sometimes)

A

Nystagmus
Tremor
Ataxia
Dizziness

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3
Q

Current standard for heparin overlap in warfarin initiation

A

5 days

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4
Q

Use of loading dose is recommended in _____ but not ______

A

Digoxin

not Warfarin

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5
Q

Warfarin mechanism of action

A

Antagonism of Vit K

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6
Q

Warfarin monitoring

A

Daily
Then Weekly
Then q 1-4 weels

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7
Q

Low intensity warfarin tx

A

Efficacy rapidly diminishes below INR of 2.0

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8
Q

High intensity warfarin tx

A

Safety is compromised at INR above 4

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9
Q

If urgent need for prompt reversal of anti-coag

A

Administer fresh frozen plasma (contains clotting factors)

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10
Q

If urgent need for prompt reversal of anti-coag, newer products

A

Prothrombin Complex Concentrate (PCC)

2 kinds, contain all vit-K dep coag factors or just II, IX, X (if second kind, use fresh frozen plasma too)

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11
Q

New anticoag, direct thrombin inhibitor

No monitoring needed

A

Pradaxa (dabigatran)

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12
Q

New anti-coag, Factor Xa inhibitor

No monitoring needed

A

Xarelto (rivaroxaban)

Also, Eliquis (apixaban)

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13
Q

Therapeutic range for digoxin

A

0.5-2.0

half life 36-38 hours, steady state 6-8 hours

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14
Q

Digoxin loading dose

A

0.25-0.5 STAT w/ 0.25 q 6-8 hours until total dose of 1.0-1.5 mg given

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15
Q

Maintenance digoxin

A

0.125-0.25 mg/d

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16
Q

Anorexia, nausea, vomiting, diarrhea, PAT w/ block

A

Dig toxicity sx

17
Q

Tx of dig tox

A

D/c drug
Cardiac monitoring
Avoid cardioversion
Ensure adeq K+

18
Q

Use for life-threatening digoxin tox

A

Digoxin specific FAB

19
Q

When to evaluate adequacy of dilantin

A

blood levels drawn just before next dose

*If toxic sx, get blood levels during sx

20
Q

Phenytonin metabolism

A

70% in liver

21
Q

Key info to know about dosing dilantin/phenytoin

A

Dose response curve not linear

Can have large increases in serum level with small increases in dose

Clin Lab Med Final (5 decks)

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