toxic meds

Question 1

Lithium (antimania drug) use

Answer 1

• Used for Bipolar

- Specifically, for the manic episodes but not for the depression

Question 2

Lithium therapeutic and toxic levels

Answer 2

• Therapeutic level: 0.6 to 1.2
• Toxic level: >2.0
• Notice gray area: 1.3 to 2

Question 3

Lanoxin or Digoxin use

Answer 3

• Used to treat A-Fib and CHF

Question 4

Lanoxin/digoxin therapeutic and toxic levels

Answer 4

• Therapeutic level: 1 to 2

* Toxic level: >2

Question 5

Aminophylline use

Answer 5

muscle spasm relaxer for the airway

• Compound of the bronchodilator theophylline

Question 6

Aminophylline therapeutic and toxic levels

Answer 6

• 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

Question 7

phenytoin (dilantin) use

Answer 7

• Seizure medication

Question 8

Dilantin (phenytoin) therapeutic and toxic levels

Answer 8

• Therapeutic level: 10-20

* Toxic level: >20

Question 9

Bilirubin purpose

Answer 9

• Breakdown product of Red Blood Cells
• Normal level in adults: 0.2 to 1.2
• Always tested in the Newborns on the NCLEX
• In Newborns bilirubin is much higher than in adults

Question 10

Bilirubin elevated and toxic levels

Answer 10

o Elevated level: 10 to 20

o Toxicity: >20

Question 11

Patterns

Answer 11

• 1s and 10s 
• 2s and 20s
o 2s: Low # (Lithium and Lanoxin)
o 20s: High # (Aminophylline, Dilantin
and Bilirubin)

Question 12

Kernicterus

Answer 12

Excess bilirubin in the brain
• Occurs when level in the blood gets >20
• In the brain, it may cause aseptic (sterile) meningitis
• It can be DEADLY

Question 13

Opisthotonos

Answer 13

• Position the newborn assume due to irritation of the meninges from kernicterus
• Presentation: hyperextended posture … (Is a medical emergency)

Question 14

When do physicians want to hospitalize newborns with jaundice?

Answer 14

When bilirubin level is about 14 to 15