Which of the following medication should be avoided if a patient is on lithium to avoid lithium toxicity?
Answer(s): C
ACE-inhibitors (such as lisinopril), NSAIDs (such as naproxen) and loop diuretics (furosemide) can all increase the risk of lithium toxicity.
Which of the following class of antidiabetic medications can increase triglycerides?
Answer(s): A
The only bile acid sequestrant, colesevelam (Welchol), has been shown to increase triglycerides through mechanism of: activation of phosphatidic acid phosphatase with promotes triglyceride synthesis. GLP-1 agonists work on GLP 1 receptors to increase insulin secretion, decrease glucagon secretion, and increase satiety. Thiazolidinediones activate nuclear transcription factor PPAR gamma to increase insulin sensitivity. SGLT2 inhibitors inhibit glucose reabsorption in the kidney. Alpha- glucosidase inhibitors slow down digestion and absorptions of carbs in the gut.
A Physician orders Dobutamine HCl IV infusion at 5 mcg/kg/min. Dobutamine HCl is available as 500 mg in 250 mL of D5W. The patient weighs 68 kg. Calculate the infusion rate in mL/hr.
68 kg × [5 mcg/kg/min] = 340 mcg/min Bag concentration = 2 mg/ml or 2000 mcg/ml 340 mcg × [1 mL/2000 mcg] = 0.17 mL/min 60 in × [0.17 mL/min] = 10.2 mLs in one hour
When does the newer chronic kidney disease (CKD) guidelines recommend stopping metformin?
Metformin should be stopped when eGFR falls below 30. This is the only cutoff that is recommended for absolute discontinuing. If the eGFR falls between 30-44 while ontherapy, benefits and risks of discontinuing should be evaluated. New initiation is only recommended when eGFR >45.
A physician orders Dopamine 5 mcg/kg/min. The concentration of the Dopamine IV bag is 400 mg in 250 D5W. The patient’s weight is 168 lbs. Calculate the infusion rate in mL/hr.
Pt’s weight in Kg 76.4. 76.4 × [5 mcg/kg/min] = 381.18 mcg/min Concentration of the bag [400 mg/250 mL] = 1.6 mg/ml or 1600mcg 381.18 mcg × [1 mL/1600 mcg] = 0.2382 mL/ml 60 in × [0.0.2382 mL/min] = 14.29 mL in one hour
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