NAPLEX Lab Values & Drug Monitoring
BMP
Basic metabolic panel
- Measures electrolytes, glucose, acid/base (HCO3), and renal function
CMP
Comprehensive metabolic panel
- BMP, plus albumin, AST/ALT, bilirubin, total protein (to assess liver function)
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Brainpower
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Blood cell count stick diagram
Electrolyte stick diagram
Leukocytosis, leukopenia
High, low WBC
Thrombocytosis, thrombocytopenia
High, low PLT
,Polycythemia, anemia
High, low RBC
myelosuppression
Bone marrow suppression (decrease WBC, RBC, PLT)
agranulocytosis
- causes?
Decrease in granulocytes (WBC with granules in cytoplasm; decrease neutrophils, basophils,
eosinophils)
- Drugs: clozapine, propylthiouracil, methimazole, procainamide, carbamazepine, isoniazid,
Bactrim
Total calcium reference range
- Correction?
- Causes for elevation? depression?
8.5-10.5 mg/dL
- Correct if low albumin (corrected Ca = Ca + 0.8(4-albumin)
- High due to thiazide diuretics, vitamin D or Ca supplements
- Low due to long term heparin, loop diuretics, bisphosphonates, cinacalcet
Magnesium reference range
- Causes for elevation? depression?
1.3-2.1 mEq/L
- High due to Mg-containing antacids, laxatives
- Low due to PPIs, diureitcs
Phosphate reference range
- Causes for increase? Decrease?
2.3-4.7 mg/dL
, - High due to renal failure
- Low due to phosphate binders, oral calcium intake
Potassium reference range
- Causes for increase, decrease?
3.5-5.0 mEq/L
- Increase: ACEi, ARBs, ARA, aliskiren, canagliflozin, cyclosporine, tacrolimus, Bactrim,
drospirenone OC, K supplements
- Decrease: beta-2 agonists, diuretics, insulin
Sodium reference range
- Causes for increase, decrease?
135-145 mEq/L
- Increase: hypertonic saline
- Decrease: carbamazepine, oxcarbazepine, SSRI, diuretics
Bicarbonate (HCO3) reference range (venous, arterial)
- Causes for increase, decrease?
Venous: 24-30, arterial: 22-26
- Increase: loop diuretics, steroids
- Decrease: topiramate, zonisamide, salicylate overdose
Blood urea nitrogen (BUN) reference range
- Causes for increase
7-20 mg/dL
- Increase: renal impairment, dehydration (BUN:SCr >20)