A patient enters the ED in a coma. The physician suspects a drug overdose. The lab performs Immunoassay screening tests for opiates, barbiturates, benzodiazepines, THC, amphetamines, and PCP. All results are negative. No ethanol was detected in the patient’s serum.
Can the physician rule out drug overdose as the cause of this coma with these results? Explain your answer.
John, a 56-year-old has congestive heart failure has been successfully treated with digoxin for several years, His wife informed the physician that he recently developed renal failure. Since the couple has been traveling internationally, his wife is concerned regarding his adherence with taking his prescribed drugs as directed by his cardiologist.
Laboratory records indicate semiannual peak digoxin concentrations that have all been within the therapeutic range. A serum specimen was collected upon admission, and the results received by the ED physician are shown in the table below. The physician reviews the results with John and his wife and indicates that John is not exhibiting signs or symptoms of digoxin toxicity.
Laboratory Results
|
Test |
Result |
Reference Interval |
|
Sodium |
129 |
135–145 mmol/L |
|
Potassium |
5.5 |
3.5–5.3 mmol/L |
|
Chloride |
113 |
97–107 mmol/L |
|
tCO2 |
16 |
21–31 mmol/L |
|
Urea nitrogen |
180 |
5–20 mg/dL |
|
Creatinine |
4.5 |
0.6–1.0 mg/dL |
|
Digoxin |
3.0 |
0.9–2.0 ng/mL |
After reviewing the results should the physician be concerned about any of these results and why?
3.If the specimen was collected without consideration of the time of the patient’s last digoxin dose, how might this affect the interpretation of the test result?
The efficacy of a drug taken by a patient is influenced by several factors. Name them.
Most drugs are not administered in a single bolus, but delivered on a scheduled basis, (i.e., once every 8 hours). What is the goal of this multiple-dosage regimen?
What are the reasons why urine is the best specimen for screening of DOA testing?
CA 19-9 is utilized clinically as a monitor marker for what cancer?
CA 125 is utilized clinically as a monitor marker for what cancer?
Name the non-specific bone enzyme tumor marker that is elevated in many bone related and liver cancers.
Discovered in the 1960’s, what marker is most widely used for colorectal cancer?
This phenomenon where excessively high tumor marker concentrations exceed the linear range which result in falsely low measurements. What is this phenomenon?