Patient selection: medication and fluid triggers (M)
Laboratory results that suggest an adverse drug reaction
(2) INR > 6
(4) aPTT > 100 seconds
(5) anti-Xa > 1.5
(6) doubling of the serum creatinine
(7) rising creatinine in a patient who has been given a nephrotoxin (aminoglycoside, cyclosporine, tacrolimus, vancomycin)
(13) serum total bilirubin > 25 mg/dL in a neonate (< 28 days old)
(14) elevated liver enzymes in a patient who has been given an hepatotoxic drug
(16) hypoglycemia with blood glucose < 40 mg/dL
Toxic serum blood concentrations:
(8) serum phenytoin > 30 µg/mL
(9) serum valproic acid > 170 µg/mL
(10) serum carbamazepine > 20 µg/mL
(11) serum oxycarbamazepine > 30 µg/mL
(12) serum phenobarbital > 30 µg/mL
Administration of an antidote:
(1) vitamin K administered to a patient receiving warfarin
(3) protamine administered to a patient receiving unfractionated heparin
(15) hyperkalemia (> 6 mmol/L) or administration of kayexalate (sodium polystyrene sulfonate)
(17) glucagon administered to a patient on insulin
(18) intravenous dextrose bolus administered to a patient on insulin
(20) flumazenil administration in a patient being treated with a benzodiazepine
(21) digoxin immune Fab administration
(23) naloxone (Narcan) administration
Clinical findings that may indicate an adverse drug reaction:
(19) abrupt medication discontinuation
(22) constipation with intermittent laxative use in a patient treated with an opiate
