Medication Information and Courses from MediaLab, Inc.

This test is sensitive to 0.06-0.1 mg/dL nitrite ion in urines with a low specific gravity and ascorbic acid concentrations of less than 25 mg/dL. Pink spots or pink edges should not be interpreted as a positive result because some medications can color urine red or turn red in an acid environment. Any degree of uniform pink color should be considered positive, suggesting the presence of 105 organisms/mL. Detection of low levels of nitrite ion may be enhanced by comparing the activated test strip to a white background. It is important to note that color development is NOT proportional to the number of bacteria present. The test is specific for nitrites and does not react with any other substances normally present in urine. Negative results do not necessarily rule out a urinary tract infection because yeasts or gram-positive bacteria unable to reduce nitrites may be the causative agent.

Some donors may inquire if they should list the medications they are taking. It is recommended that the collector suggest that when they get home, they write down all the medications they are taking on the back of their green copy of the custody and control form. In the privacy of their home, they can make sure the list is complete, and it will be handy in the event the MRO needs to contact them.

Postexposure prophylaxis will be determined by exposure type and HIV infection status of source person. The postexposure prophylaxis determined by a qualified practitioner will balance risk of infection with toxicity of the medications.The postexposure prophylaxis must be started hours after the exposure.The postexposure prophylaxis should be re-evaluated 72 hours after exposure, particularly if additional information is available about source person.The postexposure prophylaxis may be necessary for 6 months.

Therapeutic Drug Monitoring (TDM) is a branch of clinical chemistry that specializes in the measurement of medication levels in serum. TDM requires quantitative measurements of drugs and/or their metabolites.

Bioavailability refers to the amount of drug that actually reaches the circulation. It is calculated by comparing (in the same subjects) the area under the serum concentration - time curve (AUC) of an equivalent dose of the intravenous form and oral form. This is illustrated in the diagram on the right.For IV drugs, the bioavailability is 100%For oral medications, the bioavailability will be less than 100%, due in part to any of these reasons:* Oral drugs take longer to enter the circulation.* Oral drugs have slower absorption and distribution than IV drugs.* The amount of drug that is absorbed can depend on the status of the GI tract (stomach pH, presence of food, integrity/health of the intestines, speed of the GI tract, etc.)For oral drugs to be effective, bioavailability typically should be greater than 70%.Not all of a drug taken orally is able to have a pharmacologic effect; the dose would need to be higher than an IV dose.Since the absorption of an oral drug is slower than an IV drug and the drug takes longer to enter the circulation, clearing the drug will also most likely take a longer time.

TDM is not useful for these drugs or in these specific situations: Intracelluar drugs that need to be converted to active forms (like AZT) Drugs in which the effects last much longer than the serum concentrations of the drugs; examples include antineoplastics (cancer chemotherapies) and warfarin Narcotic pain medications where continued use can lead to tolerance such that the levels needed for pain relief in one person would be toxic to another person

It has been said that we live in a new era of "individualized medicine". One of the primary drivers for this idea is the emerging field of pharmacogenomics (PGx). Pharmacogenomics (PGx) is the study of how individual variations in the human genome affect responses to medications. The term "pharmacogenetics" is also used for this discipline (people in the field use both terms); however, the term 'pharmacogenomics' is becoming more popular since we now know the entire human genome. The primary reason that individuals metabolize and respond to drugs differently is the inter-individual differences in receptor proteins and enzymes that metabolize the drugs. Mutations in these receptor proteins and enzymes can give rise to very different responses to drugs. In PGx, these mutations are referred to as variants.

The blood pressure cuff was correctly inflated to 40 mmHg. The site for the incision is indeed the inside of the forearm a few inches below the bend of the elbow, and the cut was correctly made parallel to the bend of the elbow. However, the phlebotomist did not allow the alcohol to dry, and then made the additional mistake of wiping the incision with alcohol. Alcohol will retard blood coagulation, resulting in a falsely elevated bleeding time. It is also important to ask the patient about medications taken within the past week. Certain medications, particularly aspirin, will result in an elevated bleeding time.Relevant topics:Bleeding time: introduction 1, Bleeding time: introduction 2, Bleeding time: performance, Bleeding time, Apply blood pressure cuff, Bleeding time: prepare the site

The following aspects of semen analysis will be described in further detail during this course: Check the identity of the patient Record information that has been obtained from the patient including: time of collection, collection method, problems during collection, medications the patient is taking Note time to liquefaction Measure the volume by pouring into a graduated test tube or by drawing the specimen into an appropriately sized graduated serological pipet Assess viscosity Note color Measure pH by putting a drop on a strip of pH paper Count the sperm in the specimen Assess motility Count round cells, if present Assess the proportion of round cells that are white cells Fix and prepare specimen for morphology assessment; assess morphology

At the time of semen collection the patient should provide the following information that will be reported as part of the final report:The time of collectionDays of abstinenceLocation at which specimen was collected: clinic or homeDifficulties during collection (e.g. spillage)Difficulties during transport (e.g. exposure to cold temperatures)Information on collection method (e.g. masturbation, withdrawal)Names of medications that he is takingA sample supplemental information collection form is shown below:

The characteristics of the more common types of abnormal crystals are summarized in the table below. Crystal Color Significance Leucine Yellow Metabolism Tyrosine Colorless–yellow Liver disease (rare) Cystine Colorless Cystine metabolism Cholesterol Colorless Renal tubular disease Bilirubin Gold-orange Increased bilirubin High doses of ampicillin, sulfonamide drugs or other drugs may also result in urine crystal formation. It is important to check the patient’s current medications when unusual crystals are found in the urine specimen.

Patients with hypersensitivity reactions, sometimes as a result of medications, may have eosinophils in their urine. Hansel's stain, which is specific for eosinophils, or Wright-Giemsa stain may be used to distinguish these cells from neutrophils.

TB infection controls include: standardized anti-tuberculosis treatment regimens in the initial phase of therapy; rapid drug susceptibility testing; directly observed therapy in which a health professional watches a patient swallow each dose of medication and records the date that the administration was observed; improved infection control practices.