Serum chemistry

If the test is positive, the urine is examined microscopically for red blood cells. If no red blood cells are found, a tentative diagnosis of myoglobinuria is made, serum chemistries are obtained, and the patient is held to rule out rhabdomyolysis. If the uric acid and creatinine kinase (CK) values are normal, and the patient is asymptomatic, he/she is discharged from the hospital. Routine toxicology tests include urinary PCP, serum alcohol, and hypnotic screen. 

Complete blood count, serum chemistries, arterial blood gases, and antiepileptic blood levels ° Urine and blood toxicological panel... 

Any time an ABG is analyzed it is wise to concurrently inspect the serum chemistry values to calculate the anion gap. The body does not generate an anion gap to compensate for a primary disorder. As such, if the calculated anion gap exceeds 12 mEq/L (mmol/L) there is a primary metabolic acidosis regardless of the pH or the serum HC03 concentration. The anion gap may be artificially lowered by decreased serum albumin, multiple myeloma, lithium intoxication, or a profound increase in the serum potassium, calcium, or magnesium. 

Every patient with a suspected acid-base disturbance should have an arterial blood gas and a serum chemistry panel drawn concurrently. The results of these tests should be reviewed using a systematic approach to ensure proper interpretation. 

Serial arterial blood gases and serum chemistries should... 

Pulse oximeter Check blood glucose Check laboratory tests complete blood count serum chemistries liver function tests arterial blood gas blood cultures serum anticonvulsant levels urine drug/alcohol screen... 

Monitor the patient for resolution of hematuria after each successive therapeutic intervention. Frequency of monitoring is based on the severity of hemorrhaging. Monitor urinary output and serum chemistries (including sodium, potassium, chloride, blood urea nitrogen, and serum creatinine) daily for renal dysfunction. Check the CBC at least daily to monitor hemoglobin and platelet count. 

Hoffman, D.J., O.H. Pattee, S.N. Wiemeyer, and B. Mulhem. 1981. Effects of lead shot ingestion on d-ami-nolevulinic acid dehydratase activity, hemoglobin concentration, and serum chemistry in bald eagles. Jour Wildl. Dis. 17 423-431. 

In selected circumstances and secondary headache presentation, serum chemistries, urine toxicology profiles, thyroid function tests, lyme studies, and other blood tests, such as a complete blood count, antinuclear antibody titer, erythrocyte sedimentation rate, and antiphospholipid antibody titer may be considered. 

Serum chemistry profile (e.g., electrolytes, calcium, magnesium, glucose, serum creatinine, alanine aminotransferase [ALT], aspartate aminotransferase [AST])... 

Simultaneous measurement of urine and serum chemistries and calculation of the fractional excretion of sodium (FENa) can help determine the etiology of ARF (see Table 75-2). The FENa is calculated as ... 

Parker GA, Bogo V, Young RW. 1981. Acute toxicity of conventional versus shale-derived JP-5 jet fuel Light microscopic, hematologic, and serum chemistry studies. Toxicol Appl Pharmacol 57(3) 302-317. 

Monitor serum chemistry values (including blood urea nitrogen, uric acid, creatinine, phosphorus, and potassium) regularly. 

Monitoring Perform baseline and follow-up LFTs (10 to 14 days) to detect hepatic dysfunction resulting from therapy. Perform a CBC and serum chemistries. Dependence and addiction Alcoholism may accompany or be followed by dependence on narcotics or sedatives. Barbiturates have been coadministered with disulfiram without untoward effects, but consider the possibility of initiating a new abuse. 

Serum chemistry markers play an important role in hepatotoxicity evaluation in human and animal safety studies. The classic markers of hepatotoxicity are alanine aminotransferase (ALT), aspartate aminotrasnferase (AST) and alkaline phosphatase (ALP) [124—127]. Drug-induced hepatotoxicity can be difficult to assess in some circumstances. Hepatotoxic responses can be intrinsic (predictable, dose-related) or idiosyncratic (unpredictable, non-dose-related). ALT, AST and ALP are generally not useful for predicting idiosyncratic responses. The administration of some drugs, such as isoniazid, can lead to a high incidence of ALT elevation, but are tolerated by most patients without severe hepatotoxicity. Adverse drug reactions can be masked... 

LFTs before treatment and every month, CBC, serum chemistry, bone marrow assessment (including cytogenic analysis)... 

Periodic CBC, serum chemistry tests, transaminase levels... 

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