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NAPLEX > Pharm Foundations: Labs/Monitoring > Flashcards

Pharm Foundations: Labs/Monitoring Flashcards

1
Q

Agranulocytosis Definition/Drug Causes

A
  • Decrease in granulocytes (WBC that secrete granules) including neutrophils, basophils, and eosinophils
  • Drug Causes: Clozapine, propylthiouracil, methimazole, procainamide, carbamazepine, SMZ/TMP, isoniazid
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2
Q

Calcium

A
  • Corrected calcium if albumin is low
  • Increased Ca: vitamin D, thiazide diuretics
  • Decreased Ca: long-term heparin, loop diuretics, bisphosphonates, cinacalcet
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3
Q

Magnesium

A

-Decreased due to PPIs and diuretics

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4
Q

Phosphate

A

Increased in renal failure

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5
Q

Potassium

A
  • Increased: ACE-I, ARBs, aldosterone receptor antagonists, canagliflozin, cyclosporine, tacrolimus, K+ supplements, SMZ/TMP, drospirenone OC
  • Decreased: Beta-2 agonists, diuretics, insulin
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6
Q

Sodium

A

-Decreased: carbamazepine, oxcarbazepine, SSRIs, diuretics

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7
Q

Bicarbonate

A

-Decresed due to topiramate

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8
Q

BUN

A

-Increased from renal impairment and dehydration

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9
Q

SCr

A
  • Increased from drugs that impair renal function
  • Includes: aminoglycosides, amphotericin B. cisplatin, colistimethate, cyclosporine, loop diuretics, polymixin, NSAIDs, radiocontrast dye, tacrolimus, vanco
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10
Q

Anion Gap

A

-Increased anion gap suggests metabolic acidosis

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11
Q

WBC

A
  • Increased by systemic steroids

- Decreased by clozapine and carbamazepine

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12
Q

Neutrophils

A
  • Also called polymorphonuclear cells (PMNs) and segmented neutrophils (segs)
  • Bands are immature neutrophils released from bone marrow to fight infection (“left shift”)
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13
Q

Eosinophils

A

-Increased by asthma, inflammation, parasitic infection

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14
Q

Basophils

A

-Increased from hypersensitivity reaction

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15
Q

Lymphocytes

A
  • Increase by viral infection and lymphoma

- Decreased from bone marrow suppression, HIV, or systemic steroids

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16
Q

RBCs

A
  • Increased from erythropoiesis-stimulating agents (ESAs)
  • Decreased from chemotherapy agents that target bone marrow, deficiency anemias (B12/folate), hemolytic anemias, and sickle cell anemia
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17
Q

Hemoglobin (Hgb)

A
  • Increased from ESAs

- Decreased in anemias and bleeding

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18
Q

MCV

A
  • Increased from B12 and folate deficiencies

- Decreased from iron deficiency

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19
Q

Folic Acid

A
  • Folic acid and B12 are examined for macrocytic anemia
  • Decreased from phenytoin/fosphenytoin, primidone, methotrexate, SMZ/TMP
  • Supplement folate in childbearing aged women
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20
Q

Vitamin B12

A

-Decreased from PPIs and metformin

21
Q

Reticulocyte Count

A

-Decreased from untreated anemia (either type) and bone marrow suppression

22
Q

Coombs Test, Direct

A
  • AKA: DAT
  • Used to diagnose hemolytic anemia
  • Drug Causes: penicillins/cephalosporins (prolonged use/[high]), dapson, isoniazid, levodopa, methyldopa, methylene blue, nitrofurantoin, pegloticase, primaquine, quinidine, quinine, rasburicase, rifampin, and sulfonamides
  • Discontinue offending drug if hemolytic anemia is suspected
23
Q

G6PD

A
  • Hemolytic anemia due to G6PD deficiency
  • Stress and food like fava beans
  • Drug Causes: Dapsone, methylene blue, nitrofurantoin, pegloticase, primaquine, rasburicase, sulfonamides
24
Q

Anti-Xa

A
  • Used to monitor LMWH and UFH
  • Recommend to monitor in pregnancy
  • Increased from heparin and LMWHs
25
Q

PT/INR

A
  • Used to monitor warfarin
  • Increased INR from warfarin and liver disease
  • False increases to INR from daptomycin, oritavancin, and telvancin
26
Q

aPTT/PTT

A
  • Used to monitor UFH

- Falsely elevated from oritavancin and telavancin

27
Q

PLTs

A

-Decreased from heparin, LMWH, fondaparinux, linezolid, and valproic acid

28
Q

ELISA/SRA

A
  • Used to test for heparin-induced platelet antibodies
  • ELISA = first test
  • SRAs = confirmatory
29
Q

Highly Protein-Bound Drugs

A
  • Warfarin, calcium, valproic acid, and phenytoin

- Require serum concentration correction for low albumin

30
Q

AST/ALT

A
  • Used to monitor liver function

- Increased from injured hepatocytes

31
Q

Bilirubin

A

-Increased by liver damage or blocked bile duct

32
Q

Ammonia

A
  • Not diagnostic, but often monitored for hepatic encephalopathy
  • Increased by valproic acid and topiramate
  • Decreased by lactulose
33
Q

Amylase/Lipase

A
  • Increased in pancreatitis

- Drug causes: didanosine, GLP-1 agonists, DPP4-i, valproic acid, and hypertriglyceridemia

34
Q

CK/CPK

A
  • Creatinine kinase or creatinine phosphokinase
  • Used to assess muscle inflammation and damage
  • Increased: daptomycin, statins, tenofovir, raltegravir, and dolutegravir
35
Q

Troponin/B-Type Natiuretic Peptide

A
  • TnT, TnI, BNP
  • Used to diagnosis MI and are markers of cardiac stress
  • Higher values indicate increased likelihood of heart failure when consistent with symptoms
36
Q

Lipid Panel

A
  • Fasting to begin 9-12 hours before draw
  • Non-HDL = TC - HDL
  • LDL < 100
  • HDL > 60 (desirable), < 40 (low in males)
  • Non-HDL < 130
  • TG < 150
37
Q

CRP

A
  • C-reactive protein
  • 0-0.5
  • Elevated levels suggests inflammation
38
Q

FPG

A
  • > 126 consistent with diabetes
  • 100-125 is pre-diabetes
  • <100 is preferable
  • Fasting at least 8 hours
39
Q

A1C

A
  • <7% per ADA

- Average blood glucose over past 3 months

40
Q

C-peptide

A
  • Used to distinguish DMI and II

- Decreased or absent in DMI (insulin breakdown product)

41
Q

TSH

A
  • Increased TSH = hypothyroidism, Decreased TSH = hyperthyroidism
  • Levels can be affected by amiodarone and interferons
  • Increased (hypothyroidism) due to tyrosine kinase inhibitors, lithium, and carbamazepine
42
Q

Uric Acid

A
  • Used to diagnose/treat gout
  • Increased from diuretics, niacin, low dose aspirin, pyrazinamide, cyclosporine, tacrolimus, select chemotherapy and pancreatic enzyme products
43
Q

Autoimmune tests

A
  • CRP
  • RF (rheumatoid factor)
  • ESR (erythrocyte sedimentation rate)
  • ANA (antinuclear antibodies)
44
Q

DILE

A
  • Drug-induced lupus erythematosus
  • Drug Causes: anti-TNF agents, hydralazine, isoniazid, methimazole, methyldopa, minocycline, procainamide, propylthiouracil, quinidine, terbinafine
  • Discontinue causative agents if DILE suspected
45
Q

Lactic Acid

A

-Increased by metformin and NRTIs (HIV drugs)

46
Q

Prolactin

A

-Increased with haloperidol, risperidone, and paliperidone

47
Q

PPD

A
  • Purified Protein Derivative or Mantoux test

- TB skin test

48
Q

RPR

A
  • Rapid plasma reagin

- Syphilis antibody test

49
Q

TPMT

A
  • Thiopurine methyltransferase

- Deficiencies place patients at higher risk of myelosuppression if using azathioprine and mercaptopurine

NAPLEX (59 decks)

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