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NAPLEX Review UWorld > Ch 4: Lab Values & Drug Monitoring > Flashcards

Ch 4: Lab Values & Drug Monitoring Flashcards

1
Q

Drugs that causes Agranulocytosis

When the absolute neutrophil count (ANC) < 100 neutrophils/microliters

A

Clozapine
Propylthiouracil
Methimazole
Procainamide
Carbamazepine
Ioniazid
Bactrim

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2
Q

Drugs that ↑ Ca

A

Vit D
Thiazides

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3
Q

Drugs that ↓ Ca

A

Long-term heparin
Loop diuretics
Biphosphonates
Cinacalcet
Systemic steroids
Calcitonin
Foscarnet
Topiramate

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4
Q

Drugs that ↓ Mg

A

PPls,
diuretics,
amphotericin B,
foscarnet,
echinocandins,
diarrhea,
chronic alcohol intake

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5
Q

What condition causes ↑ in PO4?

A

Chronic Kidney Disease

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6
Q

Drugs that ↑ K

A

ACE inhibitors,
ARBs,
aldosterone receptor antagonists (ARAs),
aliskiren,
canagliflozin,
cyclosporine,
tacrolimus,
mycophenolate,
potassium supplements,
sulfamethoxazole/trimethoprim,
drospirenone-containing oral contraceptives,
chronic heparin use,
NSAIDs,
pentamidine .

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7
Q

Drugs that ↓ K

A

beta-2 agonists,
diuretics,
insulin,
sodium polystyrene sulfonate
steroids,
conivaptan,
mycophenolate (both ↑ and ↓ reported)

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8
Q

Drugs that ↑ Na

A

hypertonic saline,
tolvaptan,
conivaptan.

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9
Q

Drugs that ↓ Na

A

carbamazepine,
oxcarbazepine,
SSRls,
diuretics,
desmopressin

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10
Q

Drugs that ↓ HCO3

A

topiramate,
zonisamide,
salicylate overdose

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11
Q

What conditions cause an ↑ BUN?

A

renal impairment
dehydration

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12
Q

Drugs that ↑ SCr

A

aminoglycosides,
amphotericin B,
cisplatin,
colistimethate,
cyclosporine,
loop diuretics,
polymyxin,
NSAIDs,
radiocontrast dye,
tacrolimus, vancomycin

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13
Q

↑ Anion Gap suggest _

A

metabolic acidosis

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14
Q

Drugs that ↑ WBCs

A

Systemic steroids
Colony stimulating factors
epinephrine

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15
Q

Drugs that ↓ WBCs

A

clozapine,
chemotherapy that targets the bone marrow,
carbamazepine,
cephalosporins,
immunosuppressants (e.g., DMARDs, biologics)
procainamide,
vancomycin.

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16
Q

What conditions cause an ↑ eosinophils?

A

drug allergy,
asthma,
inflammation,
parasitic infection.

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17
Q

What conditions cause an ↑ Basophils?

A

inflammation,
hypersensitivity reaction,
leukemia

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18
Q

What conditions cause an ↑ lymphocytes?

A

viral infections,
lymphoma

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19
Q

What conditions cause an ↓ lymphocytes?

A

bone marrow suppression,
HIV or due to systemic steroids

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20
Q

RBCs lifespan

A

120 days

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21
Q

What conditions cause an ↑ RBCs?

A

erythropoiesis-stimulating agents (ESAs),
smoking
polycythemia (a condition that causes high RBCs

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22
Q

What conditions cause ↓ RBCs?

A

chemotherapy that targets the bone marrow,
low production,
blood loss,
deficiency anemias (e.g., B12, folate),
hemolytic anemia,
sickle cell anemia.

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23
Q

What causes an ↑ Hgb?

A

ESAs

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24
Q

What causes a ↓ Hgb?

A

Anemias
Bleeding

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25
What causes an ↑ MCV?
**B12** or **folate** deficiency | **Macrocytic anemia**
26
What causes a ↓ MCV?
**Iron** deficiency | **Microcytic anemia**
27
Drugs that ↓ folic acid
**phenytoin/fosphenytoin**, **phenobarbital**, **primidone**, **methotrexate**, **sulfamethoxazole/trimethoprim**, sulfasalazine
28
Drugs that ↓ B12
**PPIs** **Metformin** Colchicine Chloramphenicol
29
What conditions cause ↓ reticulocyte count?
untreated anemia due to iron, folate or B12 deficiency bone marrow suppression
30
Coombs Test, Direct
Used in the diagnosis of immune-mediated hemolytic anemia
31
Drugs that can cause immune-mediated hemolytic anemia
penicillins and cephalosporins (prolonged use/high concentrations), isoniazid, levodopa, methyldopa, quinidine, quinine, rasburicase rifampin sulfonamides. ## Footnote If positive D/C drug
32
G6PD deficiency is triggered by what drugs
dapsone, methylene blue, nitrofurantoin, pegloticase, primaquine, rasburicase, sulfonamides ## Footnote Also by stress or foods (**fava beans**)
33
# Anti-Factor Xa Activity When to obtain labs for LMWH?
Obtain a **peak** anti-Xa level **4 hours** after a SC dose
34
# Anti-Factor Xa Activity When to obtain labs for unfractionated heparin?
Obtain anti-Xa level **6 hours** after IV infusion starts & Q6H until therapeutic
35
What ↑ INR w/out taking warfarin?
Liver disease
36
What can falsely ↑ INR?
daptomycin ortavancin telavancin
37
What can falsely ↑ aPTT?
Oritavancin Telavancin
38
aPTT therapeutic range
1.5-2.5 x the control range ## Footnote control range depends on instituton
39
What is the average life span of platelets (PLTs)?
7-10 days
40
Drugs that ↑ platelets
**heparin**, **LMWHs**, **fondaparinux**, glycoprotein lib/Illa receptor antagonists, **linezolid**, **valproic acid**, chemotherapy that targets the bone marrow
41
Heparin-induce thrombocytopenia (HIT) is when?
Platelets drop > 50% ## Footnote ELISA test 1st, then serotonin release assay (SRA) is **confirmatory**
42
Albumin ↓ due to?
cirrhosis & malnutrition
43
What drugs are impacted by low albumin?
warfarin calcium phenytoin
44
What drugs require correction for low albumin?
phenytoin calcium
45
What enzymes are released from injured hepatocytes?
AST & ALT
46
Bilirubin, total (Tbili) is use to?
determine liver damage & detect bile duct blockage
47
Ammonia is measure when _ is suspected
hepatic encephalopathy (HE)
48
Drugs that ↑ ammonia
valproic acid topiramate
49
Drugs that ↓ ammonia
lactulose
50
What condition can cause ↑ in amylase & lipase?
pancreatitis
51
Drugs that ↑ amylase & lipase
didanosine, stavudine, GLP-1 agonists, DPP-4 inhibitors, valproic acid, hypertriglyceridemia.
52
Creatine Kinase (CK) is use to? | or Creatine Phosphokinase (CPK)
assess **muscle inflammation** (myositis) or **muscle damage** ## Footnote Also to DX cardiac conditions
53
Drugs that ↑ Creatine Kinase (CK)
**daptomycin**, quinupristin/dalfopristin, **statins**, fibrates (especially if given with a statin), emtricitabine, **tenofovir**, tipranavir, **raltegravir**, **dolutegravir**
54
Troponin is use to? | T & I
DX MI
55
B-Type Natriuretic Peptide (BNP) is? ## Footnote also N-Terminal-ProBNP (NT-proBNP)
marker of cardiac stress | ↑ BNP w/ HF symptoms indicate a higher lkelihood of HF
56
LDL normal range
< 100 mg/dL ## Footnote Fasting **9-12 hrs** prior to lipid blood draw
57
Non-HDL normal range
< 130 mg/dL
58
↑ C-reactive Protein indicates (CRP)
inflammation
59
Fasting Plasma Glucose (FPG) range
Diabetes: **≥ 126** mg/dL Prediabetes: **100-125** mg/dL ## Footnote Begin fasting **≥ 8 hrs** prior to blood draw
60
Hemoglobin A1C range
< 7% | Average blood glucose over the past **3 months** ## Footnote Per ADA
61
Estimated Average Flucose (eAG) range
< 154 mg/dL ## Footnote Per ADA
62
eAG of _ mg/dL = A1C of _ %
126 = 6%
63
Preprandial BG range
80-130 mg/dL ## Footnote Per ADA
64
Postprandial BG range
< 180 mg/dL ## Footnote Per ADA
65
C-Peptide is use to?
distinguishe between type 1 & 2 diabetes ## Footnote ↓ or absent → type 1
66
Drugs that ↑ or ↓ TSH
amiodarone interferons
67
Drugs that ↑ TSH
tyrosine kinase inhibitors lithium carbamazepine
68
Drugs that ↑ uric acid
Aspirin (low doses) B3 (niacin) Cyclosporin & tacrolimus Chemotherapy (select, due to tumor lysis syndrome) Diuretics (Loops & thiazides) Ethambutol & pyrazinamide (TB meds) Enzyme (select pancreatic enzyme products)
69
Drugs that can cause drug-induce lupus erythematosus (DILE)
anti-TN F agents, hydralazine, isoniazid, methimazole, methyldopa, minocycline, procainamide, propylthiouracil, quinidine, terbinafine
70
Drugs that ↑ lactic acids
**NRTls** **metformin** (low risk/mostly with renal disease and heart failure), alcohol, cyanide
71
Drugs that can ↑ prolactin
**haloperidol**, **risperidone**, **paliperidone**, methyldopa
72
What the screen for syphilis?
Rapid Plasma Reagin (RPR) or Veneral Diseases Research laboratory (VDRL) ## Footnote Non-treponemal antibody test
73
What drugs requires ↓ dose when patient has a genetid deficiency of thiopurine methyltransferase (TPMT)?
azathiprine mercaptopurine
74
# Therapeutic Range Carbamazepine
4-12 mcg/mL
75
# Therapeutic Range Digoxin
AF: 0.8-2 ng/mL HF: 0.5-0.9 ng/mL
76
# Therapeutic Range Gentamicin/Tobramycin | Traditional Dosing
Peak: 5-10 mcg/mL Trough: < 2 mcg/mL
77
# Therapeutic Range Lithium
0.6-1.2 mEq/mL up to 1.5 mEq/mL for acut symptoms | drawn as a trough
78
# Therapeutic Range Phenytoin/Fosphenytoin
10-20 mcg/mL ## Footnote If albumin is loaw, calculate a corrected level
79
# Therapeutic Range Free Phenytoin
1-2.5 mcg/mL
80
# Therapeutic Range Procainamide
4-10 mcg/mL
81
# Therapeutic Range NAPA (Procainamide Active Metabolite)
15-25 mcg/mL
82
# Therapeutic Range Combined Procainamide
10-30 mcg/mL
83
# Therapeutic Range Theophylline
5-15 mcg/mL
84
# Therapeutic Range Valproic acid
50-100 mcg/mL ## Footnote up to 150 mcg/mL in some patients
85
# Therapeutic Range Vancomycin
15-20 mcg/mL for most serious infections 10-15 mg/mL for others | Trough ## Footnote Srious infections: pneumonia, endocarditis, steomyelitis, meningitis, bacteremia
86
About how many t1/2 lives to reach steady state.
5
87
# Brand:Generic BiDil
hydralazine/isosorbide dinitrate

NAPLEX Review UWorld (17 decks)

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