Lithium
antimania, bipolar use but only for the mania not depression
therapeutic: 0.6-1.2
toxic: greater than 2.0
think “L…low; 2 versus 20”
Lanoxin
dig; Afib and CHF
therapeutic: 1-2
toxic: greater than 2
think “L…low; 2 versus 20”
If you get a level of 2 for Lanoxin, what would you consider it?
toxic, safer to call it toxic than therapeutic
Aminophylline
muscle spasm relaxer, spasms of the airway, technically not a bronchodilator
therapeutic: 10-20
toxic: greater than 20
“not an L, not the low one…”
If you get a level of less than 10 for aminophylline, what would you conclude?
not therapeutic, need more or are they even taking it?
Dilantin
anti-seizure
therapeutic: 10-20
toxic: greater than 20
“not an L, not the low one”
Bilirubin
not a drug, waste of the breakdown of RBC
-only tested in newborns for NCLEX
elevated level: 10-20
toxic: greater than 20
when do doctors think about hospitalizing these newborns?
when bilirubin is halfway to toxic…14-15
Kernicterus
bilirubin in the brain (through BBB)
when bilirubin greater than 20, think its in CSF
-these babies can die
Jaundice
bilirubin in the skin
Opisthertonus
position of HTN seen in kernicterus
- heals to head bending
- arching of the neck, neck off the bed
What do you do when you see your newborn patient in opisthertonus?
place baby on its side
physiologic versus pathologic
physiologic: normal at birth…goes up day 2-3 (normal finding)
pathologic: come out yellow, something is wrong
