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Final NAPLEX > Learning Lab Values & Drug Monitoring > Flashcards

Learning Lab Values & Drug Monitoring Flashcards

1
Q

List three drugs that can increase calcium

A
  1. calcium supplementation
  2. vitamin D
  3. thiazide diuretics
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2
Q

List eight drugs that can decrease calcium

A
  1. systemic steroids
  2. long-term heparin
  3. loop-diuretics
  4. bisphosphonates
  5. cinacalcet
  6. calcitonin
  7. foscarnet
  8. topiramate
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3
Q

List two drugs that can increase magnesium

A
  1. magnesium containing antacids

2. magnesium containing laxatives

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4
Q

List five drugs + 2 conditions that can decrease magnesium

A
  1. PPI
  2. diuretics
  3. amphotericin
  4. foscarnet
  5. echinocandins
  6. diarrhea
  7. chronic alcohol intake
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5
Q

List three drugs that can decrease phosphate

A
  1. phosphate binders
  2. foscarnet
  3. oral calcium intake
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6
Q

List thirteen drugs that can increase potassium

A
  1. ACE/ARB
  2. aldosterone receptor antagonists
  3. aliskiren
  4. NSAIDs
  5. cyclosporine
  6. tacrolimus
  7. mycophenolate
  8. potassium supplements
  9. drosperinone-containing oral contraceptives
  10. bactrim
  11. chronic heparin use
  12. canagliflozin
  13. pentamidine
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7
Q

List six drugs that can decrease potassium

A
  1. steroids
  2. beta-2 agonists
  3. conivaptan
  4. diuretics
  5. insulin
  6. mycophenolate (both increase and decrease reported)
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8
Q

List three drugs that can increase sodium

A
  1. hypertonic saline
  2. conivaptan
  3. tolvaptan
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9
Q

List five drugs that can decrease sodium

A
  1. carbamazepine
  2. oxcarbazepine
  3. SSRIs
  4. diuretics
  5. desmopressin
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10
Q

List three drugs that can increase bicarbonate

A
  1. loop diuretics
  2. systemic steroids
  3. sodium acetate
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11
Q

List three drugs that can decrease bicarbonate

A
  1. topiramate
  2. zonisamide
  3. salicylate overdose
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12
Q

List two drugs that can cause false elevations of serum creatinine

A
  1. Bactrim

2. H2RAs

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13
Q

List eleven drugs that can cause true elevations of serum creatinine

A
  1. aminoglycosides
  2. amphotericin B
  3. cisplatin
  4. colistimethate
  5. cyclosporine
  6. loop diuretics
  7. polymyxin
  8. NSAIDs
  9. radiocontrast dye
  10. tacrolimus
  11. vancomycin
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14
Q

List three conditions that can cause decrease in serum creatinine (e.g. falsely reflect kidney function)

A
  1. low muscle mass
  2. amputation
  3. hemodilution
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15
Q

List three drugs that can increase WBC

A
  1. systemic steroids
  2. colony stimulating factors
  3. epinephrine
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16
Q

List seven drugs that can decrease WBC

A
  1. clozapine
  2. chemotherapy that targets bone marrow
  3. carbamazepine
  4. cephalosporins
  5. immunosuppressants (DMARDs, biologics, etc.)
  6. procainamide
  7. vancomycin
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17
Q

List four conditions that can increase eosinophils

A
  1. drug allergy
  2. asthma
  3. inflammation
  4. parasitic infection
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18
Q

List three conditions that can increase basophils

A
  1. inflammation
  2. hypersensitivity reaction
  3. leukemia
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19
Q

List two conditions that can increase lymphocytes

A
  1. viral infections

2. lymphoma

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20
Q

List two conditions + 1 drug that can decrease lymphocytes

A
  1. bone marrow suppression
  2. HIV
  3. systemic steroids
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21
Q

List three conditions that can increase monocytes

A
  1. chronic infections
  2. inflammation
  3. stress
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22
Q

List 2 drugs + 1 condition that can increase RBC

A
  1. erythropoiesis-stimulating agents (ESA)
  2. smoking
  3. polycythemia
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23
Q

List six conditions that can decrease RBC

A
  1. chemotherapy that targets bone marrow
  2. low production
  3. blood loss
  4. deficiency anemias (B12, folate)
  5. hemolytic anemia
  6. sickle cell anemia
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24
Q

List one drug that can increase Hgb/Hct

A
  1. erythropoiesis-stimulating-agents
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25
Q

List two drugs/conditions that can decrease Hgb/Hct

A
  1. anemias

2. bleeding (anticoagulants, antiplatelets, P2Y12 inhibitors, fibrinolytics)

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26
Q

List two conditions that can increase mean corpuscular volume (MCV)

A
  1. B12 deficiency

2. folate deficiency

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27
Q

List one condition that can decrease mean corpuscular volume (MCV)

A
  1. iron deficiency
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28
Q

List one drug that can increase Iron levels

A
  1. iron supplementation
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29
Q

List two conditions that can decrease iron levels

A
  1. blood loss

2. poor nutritional intake

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30
Q

List six drugs that can decrease folic acid

A
  1. phenytoin/fosphenytoin
  2. phenobarbital
  3. primidone
  4. methotrexate
  5. sulfasalazine
  6. sulfamethoxazole/trimethoprim
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31
Q

List four drugs that can decrease Vitamin B12 levels

A
  1. PPI
  2. metformin
  3. colchicine
  4. chloramphenicol
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32
Q

List ten drugs that can result in a positive Coombs test (also known as Direct Antiglobulin Test [DAT])

A
  1. penicillins
  2. cephalosporins
  3. isoniazid
  4. levodopa
  5. methyldopa
  6. nitrofurantoin
  7. quinidine
  8. quinine
  9. rifampin
  10. sulfonamides
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33
Q

List twelve drugs that can result in hemolytic anemia due to Glucose-6-phosphate dehydrogenase deficiency (G6PD)

A
  1. stress
  2. fava beans
  3. chloroquine
  4. dapsone
  5. methylene blue
  6. nitrofurantoin
  7. primaquine
  8. probenecid
  9. quinidine
  10. quinine
  11. rasburicase
  12. sulfonamides
34
Q

When should a antifactor Xa activity (Anti-Xa) be drawn

A

4 hours after SC LMWH dose

35
Q

List six conditions which might warrant Anti-Xa monitoring

A
  1. pregnancy
  2. obesity
  3. low body weight
  4. pediatrics
  5. elderly
  6. renal insufficiency
36
Q

List three drugs which can increase anti-Xa levels

A
  1. heparin
  2. LMWH
  3. fondaparinux
37
Q

List three drugs which falsely elevate INR

A
  1. daptomycin
  2. oritavancin
  3. telavancin
38
Q

List seven drugs which decrease platelets

A
  1. heparin
  2. LMWH
  3. fondaparinux
  4. glycoprotein IIb/IIIa receptor antagonists (ReoPro, Integrilin, Aggrastat)
  5. linezolid
  6. valproic acid
  7. chemotherapy that targets bone marrow
39
Q

List two tests used to diagnose Heparin-induced thrombocytopenia (HIT)

A
  1. First ELISA test, then if positive,

2. a Serotonin release assay (SRA) is confirmatory.

40
Q

List two conditions that can decrease albumin

A
  1. cirrhosis

2. malnutrition

41
Q

List three drugs/levels which require correction for low albumin

A
  1. phenytoin
  2. valproic acid
  3. calcium
42
Q

List two drugs which can increase ammonia

A
  1. valproic acid

2. topiramate

43
Q

List one drug which can decrease ammonia

A
  1. lactulose
44
Q

List four drugs and one condition which can cause elevations in amylase/lipase (e.g. pancreatitis markers)

A
  1. didanosine
  2. stavudine
  3. GLP-1 agonists
  4. valproic acid
  5. hypertriglyceridemia
45
Q

List nine drugs which can increase Creatinine Kinase

A
  1. daptomycin
  2. quinupristin/dalfopristin
  3. statins
  4. fibrates
  5. emtricitabine
  6. tenofovir
  7. tipranavir
  8. raltegravir
  9. dolutegravir
46
Q

Fasting begins x hours prior to lipid blood draw

A

9-12 hours

47
Q

Fasting begins x hours prior to Fasting Plasma Glucose

A

8+ hours

48
Q

List two drugs which can increase or decrease Thyroid Stimulating Hormone (TSH)

A
  1. amiodarone

2. interferons

49
Q

List four drugs which can increase thyroid stimulating hormone (TSH)

A
  1. interferons
  2. tyrosine kinase inhibitors
  3. lithium
  4. carbamazepine
50
Q

List eight drugs which can elevate uric acid

A
  1. diuretics
  2. niacin
  3. high doses of aspirin
  4. pyrazinamide
  5. cyclosporine
  6. tacrolimus
  7. select pancreatic enzyme products
  8. chemotherapy (tumor lysis syndrome)
51
Q

List ten drugs which can cause Drug-induced lupus erythematosus (DILE)

A
  1. anti-TNF agents
  2. hydralazine
  3. isoniazid
  4. methimazole
  5. methyldopa
  6. minocycline
  7. procainamide
  8. propylthiouracil
  9. quinidine
  10. terbinafine
52
Q

List three tests which can help establish diagnosis of drug-induced lupus erythematosus

A
  1. Antinuclear antibodies (ANA)
  2. Histone antibody (detected by ELISA)
  3. anti-dsDNA
53
Q

List two lab values that can increase with testosterone supplementation

A
  1. total free testosterone

2. prostate-specific antigent (PSA)

54
Q

What lab value is tested to determine pregnancy?

A

Human Chorionic Gonadotropin (hCG)

55
Q

List four drugs which can increase lactic acid

A
  1. NRTIs
  2. metformin
  3. alcohol
  4. cyanide
56
Q

List four drugs which can increase prolactin

A
  1. haloperidol
  2. risperidone
  3. paliperidone
  4. methyldopine
57
Q

List one drug which can decrease prolactin

A

Bromocriptine

58
Q

What test is used to screen for syphilis?

A
  1. Rapid Plasma Reagin
59
Q

List four drugs which can increase serum osmolality

A
  1. mannitol
  2. ethylene glycol
  3. methanol
  4. propylene glycol
60
Q

List two drugs which may require lower doses in patients with genetic deficiency of Thiopurine Methyltransferase (TPMT)

A
  1. azathioprine

2. mercaptopurine

61
Q

TDM level of carbamazepine

A

4-12 mcg/mL

62
Q

TDM level of digoxin for Afib

A

0.8-2 ng/mL

63
Q

TDM level of digoxin for HF

A

0.5-0.9 ng/mL

64
Q

TDM of gentamicin, peak

A

5-10 mcg/mL

65
Q

TDM of gentamicin, trough

A

<2 mcg/mL

66
Q

TDM of lithium, acute symptoms

A

1.5 mEq/L

67
Q

TDM of lithium, maintenance

A

0.6-1.2 mEq/L

68
Q

TDM of phenytoin/fosphenytoin

A

10-20 mcg/mL

69
Q

TDM of free phenytoin

A

1-2.5 mcg/mL

70
Q

TDM of N-acetylprocainamide (NAPA)

A

15-25 mcg/mL

71
Q

TDM of procainamide

A

4-10 mcg/mL

72
Q

TDM of combined NAPA and procainamide

A

10-30 mcg/mL

73
Q

TDM of theophylline

A

5-15 mcg/mL

74
Q

TDM of tobramycin, peak

A

5-10 mcg/mL

75
Q

TDM of tobramycin, tourhg

A

<2 mcg/mL

76
Q

TDM of valproic acid

A

50-100 mcg/mL (up to 150 mcg/mL in some patients)

77
Q

TDM of vancomycin, non-severe infection, trough

A

10-15 mcg/mL

78
Q

TDM of vancomycin, severe infection, trough

A

15-20 mcg/mL

79
Q

TDM of warfarin, most indications

A

INR 2-3

80
Q

TDM of warfarin, mechanical mitral valve

A

INR 2.5-3.5

Final NAPLEX (15 decks)

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