Thera 1 Lab Values

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PharmD2014
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113296
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Thera 1 Lab Values
Updated:
2011-11-01 05:12:38
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Lab Values
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Therapeutics I Lab Values
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  1. Metabolic Panel Diagram
  2. Blood Count Diagram
  3. Hematocrit (Hct) - Females
    34-47%
  4. Hematocrit (Hct) - Males
    40-50%
  5. Hemoglobin (Hgb) - Females
    12-16 g/dL
  6. Hemoglobin (Hgb) - Males
    14-18 g/dL
  7. WBC
    3,500-10,000 cells/mm3
  8. Neutrophils
    • 54-62%
    • increase in bacterial or fungal infection
    • ANC < 2000: Neutropenia
    • ANC <1000: Risk of infxn
    • ANC < 500: Agranuloctosis; associated w/ high risk of infxn
  9. Lymphocytes
    • 25-33%
    • increase in VIRAL infections, syphilis, mono
  10. Monophils
    3-7%
  11. Eosinophils
    • 1-3%
    • increase in allergies or parasitic infections
  12. Basophils
    • <1%
    • increase in allergies or inflammation
  13. What makes up the "Diff"?
    • "Nobody Likes My Educational Background"
    • - Neutrophils
    • - Lymphocytes
    • - Monophils
    • - Eosinophils
    • - Basophils
  14. Platelets
    • 150,000-400,000 cells/mm3
    • High (thrombocytosis) - can lead to clot formation
    • Low (thrombocytopenia) - excessive bledding; can be drug-induced (i.e. heparin, bactrim, ASA)
  15. Mean Cell Volume (MCV)
    75-100 fL
  16. Mean Corpuscular Hemoglobin Concentration (MCHC)
    33-37 g/dL
  17. RBC count
    • males: 4.3-5.9x 106 cells/mm3
    • females: 3.5-5 x106 cells/mm3
  18. Sodium
    136-146 mEq/L
  19. Hypernatremia
    • Altered mental state (AMS)
    • thirst
    • decreased urine output
    • lethargy
    • seizures
  20. Hyponatremia
    • Altered mental state (AMS)
    • seizures
    • disorientation
    • muscle cramps
    • * Trileptal (oxcarbazepime) and Tegretol (carbamazepime) DECREASE Na
  21. Potassium
    3.5-5 mEq/L
  22. Hyperkalemia
    • Cardiac arrhythmia
    • Bradycardia
    • Hypotension
    • *ACE-I/ARBs INCREASE K
  23. Hypokalemia
    • Fatigue
    • Cardiac arrhythmias
    • muscle weakness/cramps
    • *Insulin, loop diuretics DECREASE K
  24. Chloride
    95-105 mEq/L
  25. HCO3
    22-28 mEq/L
  26. BUN
    8-28 mg/dL
  27. BUN elevation
    • increase = indicates renal dysfunction
    • affected by muscle mass
    • Hypovolemia, shock, MI, sepsis, renal infection/failure
  28. Creatinine (SCr)
    0.6-1.2 mg/dL
  29. Creatinine Elevation
    • increase = renal dysfunction
    • affected by muscle mass
    • Metformin is CI:
    • - SCr >= 1.5 in males
    • - SCr >= 1.4 in females
  30. Glucose
    70-100 mg/dL
  31. Pre-Diabetes glucose level
    100-125 mg/dL
  32. Diabetes glucose level
    >= 126 mg/dL
  33. Diabetic A1C
    >= 6.5%
  34. Diabetic Goals (A1C, FPG, PPG, BP, LDL)
    • A1C < 7%
    • Fasting glucose = 70 - 130 mg/dL
    • Postprandial glucose < 180 mg/dL
    • BP < 130/80
    • LDL < 100
  35. Calcium
    • 8.6-10.2 mg/dL
    • neuromuscular function
    • bone formation
    • **correct for decrease Albumin levels!!!
    • inversely related to phosphate (forms complex)
  36. Hypercalcemia
    • weakness
    • anorexia
    • constipation
    • N/V
  37. Hypocalcemia
    • muscle cramps
    • tingling fingers
    • tetany
    • seizures
  38. Amylase
    • 30-100 IU/L
    • helps digest carbohydrates
  39. Amylase elevation
    • Pancreatic injury
    • Acute pancreatitis
    • Obstruction of pancreatic duct by gallstone or tumor
  40. Lipase
    • 0-160 IU/L
    • helps digest fats
    • *more specific for pancreatic dz than amylase!!
  41. Lipase elevation
    • Pancreatic injury
    • Acute pancreatitis
    • Obstruction of pancreatic duct by gallstone or tumor
  42. AST
    • 2-35 IU/L
    • Aspartate aminotransferase (AST)
    • Found primarily in heart and liver
    • - increase in MI increase
    • - in acute hepatic necrosis
    • - Concern: 4x the UNL (upper normal limit)
    • - levels do not correlate with extent of liver damage
  43. ALT
    • 0-45 IU/L
    • Found primarily in liver (more liver specific)
    • Released during cell injury
    • - concern: 4x the UNL
    • - levels do not correlate with extent of liver damage
  44. Alkaline Phosphatase (Alk Phos)
    • 30 - 120 IU/L
    • 80% AlkPhos comes from liver and bone
    • (also, sm intestine, kidney, placenta)
  45. AlkPhos Elevation
    • Hepatitis
    • Liver disease
    • Pancreatitis
    • Bone disorders (cancer, Paget's disease)
  46. Gamma-Glutamyl Transpeptidase (GGT)
    • Test to differentiate between bone and liver disease
    • Increase AlkPhos + increase GGT = Liver dz
    • Increase AlkPhos + normal GGT = bone disorder
  47. Total bilirubin
    0.1-1mg/dL
  48. Albumin
    • 4-6 g/dL
    • primary plasma protein
    • synthesized by liver
    • major determinant of colloidal osmotic pressure
  49. Decreased Albumin
    • overhydration
    • malnutrition
    • cancer
    • severe burns
    • pregnancy
    • cirrhosis
    • hepatitis
    • liver failure
  50. Hypoalbuminemia
    • leads to Edema Ascites
    • - (leaking fluid)
  51. medications/elements that bind to Albumin
    • Phenytoin
    • Warfarin
    • Ca
  52. Liver Dysfunction indicators
    • low albumin,
    • high AST
    • high ALT
    • high Alkphos
  53. TSH
    0.3 - 5 uIU/L
  54. T4
    • 5 - 12 ug/dL
    • Thyroxine
  55. Free T4
    0.8 - 2.2 ng/dL
  56. T3
    • 75 - 200 ng/dL
    • Triiodothyronine
  57. Hypothyroidism
    • ELEVATED TSH
    • Decrease T3, T4
    • Sxs:
    • - cOld intolerance
    • - Weight GAIN
    • - Depression
    • - Fatigue
    • - Constipation
    • - Sluggishness
    • - Inc cholesterol
  58. Subclinical HypOthyroidism
    • INCREASE TSH
    • Normal T3, T4
  59. Hyperthyroidism
    • Decreased TSH
    • INCREASED T3, T4
    • Sxs:
    • - Tachycardia
    • - Heat intolerance
    • - Weight loss
    • - Nervous, irritable
    • - Diarrhea
    • - Difficulty sleeping
    • - Sweating
  60. Total Cholesterol (TC)
    • <200 = Desireable
    • 200 - 239 = Borderline High
    • ≥ 240 = High
  61. LDL
    • < 100 = Optimal
    • 100 - 129 = Near/above optimal
    • 130 - 159 = Borderline high
    • 160 - 189 = High
    • ≥ 190 = Very High
  62. HDL
    • < 40 = Low
    • ≥ 60 = High
    • F: >50-55
    • M: >40-45
  63. Triglycerides (TG)
    • Normal: < 150
    • Borderline High: 150 - 199
    • High: 200 - 499
    • Very High: ≥ 500 --> increase risk for pancreatitis
  64. BMI
    - eqns
    - classifications
    • BMI = kg/m2
    • BMI = lbs/in2 *703
    • - overestimated in muscular pts
    • - underestimated in muscle atrophy pts

    • < 18.5 = Underweight
    • 18.5 - 24.9 = Normal Weight
    • 25 - 29.9 = Overweight
    • 30 - 34.9 = Obesity Class I
    • 35 - 39.9 = Obesity Class II
    • ≥ 40 = Extreme Obesity
  65. Blood Pressure
    • Normal: ≤ 120/80 mmHg
    • Hypertension: SBP > 140 OR DBP > 90
    • Hypertensive Urgency: > 180/20 + NO s/sxs of target organ damage
    • Hypertensive Emergency: > 180/20 + s/sxs of target organ damage
  66. Kidney Dysfucntion
    • Stage 1: ≥ 90 mL/min
    • Stage 2: 60 - 80
    • Stage 3: 30 - 59
    • Stage 4: 15 - 29
    • Stage 5: < 15 + dialysis [Kidney Failure]
  67. Magnesium
    • 1.5 - 2.3 mEq/L
    • excreted renally
    • Hyper/Hypo: cardiac arrhythmia
  68. Target BP in HTN pts
    • BP < 140/80
    • BP < 130/80 for special populations (DM, CAD, CKD, post MI, HF)
  69. Vancomycin
    Trough: 10 - 20 mcg/mL
  70. Gentamycin/Tobramycin
    • Peak: 5 - 10 mcg/mL
    • Trough: < 2 mcg/mL
  71. Lithium
    Maintenance: 0.6 - 1.2 mEq/L
  72. Valproic Acid
    50 - 125 mcg/mL (therapeutic conc.)
  73. Phenytoin
    10 - 20 mcg/mL
  74. Low Hbg/Hct + _____ MCV:
    • Low MCV (<75) = microcytic anemia (iron deficiency or sickle cell anemia)
    • High MCV (>100) = macrocytic anemia (folic acid or vit B12 deficiency - pernicious anemia)
  75. Liver Dysfunction
    • Weakness, fatigue
    • Loss of appetite
    • N/V
    • Abdominal swelling/pain
    • Jaundice
    • Dark urine
    • Light colored stool

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