Appendix A. Drug Sample Type Interference Physiological/Pharmological or Methodological (M) Effect Acetaminophen Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Plasma Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Hemoglobin ↓ Methemoglobin ↑ Neutrophils ↓ Red Cell Count ↓ White Cell ↓ Prothrombin Time ↑ Bilirubin ↑ Creatinine ↑ Direct Bilirubin ↑ Glucose ↓ Iceteric Index ↑ SGOT ↑ SGPT ↑ Urea Nitrogen ↑ Uric Acid ↑ Protein ↑ Sulfate ↓ Uric Acid ↑ UA Bile ↑ UA Casts ↑ UA Cells ↑ UA Methemoglobin ↑ UA Protein ↑ UA RBC/ HPF ↑ Volume ↓ Bleeding Time ↑ Eosinophils ↑ Erythrocyte Survival ↓ Factor VII ↓ Heinz-Body Formation + Hematocrit ↓ Hemoglobin ↓ Methemoglobin ↑ PCO2 ↓ pH ↓ pH ↑ Anemia/ Pancytopenia May Rarely Cause Hemolysis May Cause Neutropenia/Pancytopenia May Cause Hemolytic Anemia May Affect Bone Marrow Function/ Pancytopenia Depresses Clotting Factor Synthesis Hepatic Damage Reported With Overdose Reversible Tubular Necrosis Reported Hepatic Necrosis With Dose of 10g Reported Reported Effect of Metabolite May Cause Hepatic Toxicity Hepatic Necrosis With Dose of 10g Reported Hepatic Necrosis With Dose of 10g Reported Reversible Tubular Necrosis Reported Falsely High Values With Phosphotungstate Methods (M) Renal Damage May Occur Reduces ↑d Output of Rheumatoids Falsely High Values With Phosphotungstate Methods (M) Hepatic Necrosis May Occur With Dose of 10g Renal Damage Due to Hemolysis/Anuria May be Marked ↑ in Renal Tubular Cells Renal Damage Due to Hemolysis Nephrotoxic Effect of Drug Renal Damage Due to Hemolysis ↑ Transport of Water in Diabetes Insipidus Also Inhibits Platelet Glycolysis May Cause Aplastic Anemia or Pancytopenia Large Doses ↑ Destruction Acts Like Bishydroxycoumarin Occur Initially but Disappear with Hemolysis Depresses Bone Marrow, G.I. Bleeding, Hemolytic Anemia Depresses Bone Marrow, G.I. Bleeding, Hemolytic Anemia May Cause Hemolysis with G6PD In Toxicity with ↑ Respiratory Rate and Pulm Vent May Cause Acidosis Later (Respiratory and Metabolic) Initial Respiratory Alkalosis Acetylsalicylic Acid SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Cerebrospinal Fluid Erythrocyte Fecal Fecal Other Bodily Fluid Plasma Plasma Plasma Plasma Plasma Plasma Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Platelet Aggregation ↓ Platelet Count ↓ Red Cell Count ↓ Reticulocytes ↑ Sedimentation Rate ↓ Sedimentation Rate ↑ White Cell Count ↓ Protein ↑ Reduced Glutathione ↓ Color ↑ Occult Blood + Basal Metabolic Rate Fibrinogen ↑ Hemoglobin ↑ Prothrombin Time ↓ Prothrombin Time ↑ Thyroid Stimulating Hormone↓ 17 Hydroxy Corticosteroids ↑ Acetoacetate ↑ Albumin ↓ Aldolase ↑ Alkaline Phosphatase ↑ Amylase ↑ Barbiturate ↑ Bilirubin ↑ Calcium Bilirubin ↓ Cholesterol ↓ Cholesterol ↑ CO2 Content ↓ CO2 Content ↑ Direct Bilirubin ↑ Free Thyroxine ↑ Serum Serum Serum Free Triiodothyronine ↑ Glucose ↓ Glucose ↑ Serum Serum Serum Iodine 131 Uptake ↓ Iron ↓ Ketones ↓ Inhibits Release of ADP From Platelets ↓ Platelet Survival Time, May be Purpura Hemolysis/ G6PD/ G.I. Hemorrhage/ Direct Bone Marrow Depression Response During Recovery From Hemolysis If Elevated Reduces Toward Normal Value Occurs in Some Patients (Reversible) Depress Leukocytosis of Acute Rheumatic Fever False + with Folin-Ciocalteu Reagent (M) Occurs Initially Before Overt Hemolysis Red or Black Due to Gastrointestinal Bleeding In Over 70% Patients When More Than 3g/Day Given Reported Metabolic Effect Associated with ↑ Sedimentation Rate Occurs with Hemolytic Anemia Small Dose Effect Large Dose Effect (↓ Synthesis of Clot Factors) Release After Administration Large Dose Stimulate Adrenocortical Activity Due to Late Metabolic Acidosis and Renal Impair Decreased Dye Binding Capacity (M) Experimental Effect Seen in Rabbits with Prolonged Use Prolonged Use May Cause Hepatic Toxicity Single Case Reported May Interfere with UV Spectrophotometry (M) Competition For Albumin Binding Depresses Fluorescence of Calcein Method (M) Doses Over 5g Reported to Have Effect Alleged Effect (M) Initial Acidosis with Excessive Doses Later Alteration of Acid Base Balance Occurs with Hemolytic Anemia Interferes with Binding to Thyroxine Binding Globulin and Thyroxine Binding Prealbumin Interferes with Binding to Thyroxine Binding Globulin In Diabetics and if Toxic Doses Ingested ↑ Absorption and Steroid Release Inhibits Trichloroacetic Acid or Tricarboxylic Acid With Large Doses and Chronic Administration May Be Markedly Reduced with Large Doses ↑ Oxidation of Ketone Bodies in Diabetics SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Ketones ↑ Lactate ↑ Lactate Dehydrogenase ↑ Non Esterified Fatty Acids↓ Protein-Bound Iodine ↓ Due to Induced Acidosis Due to Late Metabolic Acidosis and Renal Impair Experimental Effect Seen in Rabbits with Prolonged Use ↑ Fatty Acid Oxidation, ↓ Lipogenesis Competes For Thyroxine Binding Prealbumin Also Uncouples Phosphorylation Phospholipids ↓ ↑ Fatty Acid Oxidation, ↓ Lipogenesis Potassium ↓ Diuretic Action, Respiratory Alkalosis Pyruvate ↑ Due to Late Metabolic Acidosis and Renal Impair Salicylate ↑ Due to Ingestion of Compound SGOT↑ Prolonged Admin, May Cause Hepatic Toxicity SGPT ↑ Prolonged Use May Cause Hepatic Toxicity Thyroxine (T4) ↓ Displaces Thyroxine From Binding Sites Triiodothyronine Uptake ↑ Red Cell Uptake Affected Also Affects Resin Test Urea Nitrogen ↑ May Have Nephrotoxic Effect Uric Acid ↓ Mild Uricosuric Action (Large Dose Effect) Uric Acid ↑ Acts as Reducing Substance with Non-Specific Methods (M) Uric Acid ↑ Small Dose Effect Uric Acid ↑ Low Doses Reduce Renal Excretion of Uric Acid 5-Nucleotidase ↑ Reversible Hepatotoxicity with Prolonged Admin Acetoacetate ↑ Reacts with Gerhardt Ferric Chloride Procedure (M) Acetoacetate ↑ Acidotic Response Especially in Children Alkaline Phosphatase ↑ Due to Nephrotoxic Effect of Drug Alpha Amino Nitrogen ↑ Inhibition of Reabsorption, ↑ Protein Catabolism Amino Acids ↑ Two Fold ↑ After 1.6g in Normal Ascorbic Acid ↑ Reported Effect Bicarbonate ↑ Response to Respiratory Alkalosis of Early Toxicity Catecholamines ↑ Interfering Fluorescence in Many Procedures (M) Dihydroxyphenylalanine Screen + Light Amber Color Produced (M) Fouchet Test + Produces Purple Color (M) Glomerular Filtration Rate ↓ Nephrotoxicity of Drug Occurring Acutely Glucose ↓ Glucose Oxidase Methods Inhibited by Gentisic Acid (M) Glucose ↑ Inhibits Liver and Muscle Glycogen Synthesis Homogentisic Acid ↑ Interferes with Measurement Procedure (M) Ketones ↓ ↑ Oxidation of Ketone Bodies in Diabetics Ketones ↑ Reddish Color with Gerhardt's Test (M) Lactic Dehydrogenase ↑ Renal Irritation & Desquamation of Epithelial Cells Leucine Aminopeptidase ↓ Due to Antifibrinolytic Action Nitrogen ↑ Effect Observed in Adults Phenylketones + Purple with Ferric Chloride, Purple with Phenistix (M) SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Albumin Cerebrospinal Fluid Serum Albumin, Human Serum Alkaline Serum Amphotericin B Whole Blood Whole Blood Whole Blood Whole Blood Fecal Plasma Serum Serum Serum Phosphate ↑ Potassium ↑ Protein ↑ Protein ↑ Phenosulfonphalein Excretion ↓ Sodium ↑ Sugar ↑ Taurine ↓ Uric Acid ↓ Uric Acid ↑ Uric Acid ↑ UA Casts ↑ UA Cells ↑ UA Glucose ↓ UA Glucose ↑ UA Hemoglobin ↑ UA Ketones ↓ UA Ketones ↑ UA Protein ↑ UA RBC/ HPF ↑ UA Sugar ↑ UA WBC/ HPF ↑ Vanillylmandelic Acid ↑ Volume ↑ Xylose Excretion ↓ 17 Hydroxy Corticosteroids ↓ Ascorbic Acid ↓ Protein ↓ Thymol Turbidity ↑ Phosphatase ↑ Protein-Bound Iodine ↑ Hematocrit ↓ Hemoglobin ↓ Platelet Count ↓ Red Cell Count ↓ Occult Blood + Effective Renal Plasma Flow ↓ Alkaline Phosphatase ↑ Bilirubin ↑ Bromosulfophthalein Retention ↑ Inhibits Tubular Reabsorption Direct Effect on Renal Tubules Interference with Folin-Ciocalteu Reaction (M) May Cause Nephrotoxicity Competes with Phenosulfonphalein for Excretion Response to Respiratory Alkalosis of Early Toxicity False + with Clinitest or Benedict's (M) Reduces Elevated Concentration in Rheumatoid Patients Low Doses Effect Acts as Reducing Substance with Non-Specific Methods (M) High Dose Effect (Greater Than 3g daily) Occurs with Poisoning Tubular Epithelial Cells ↑ Initially, May Persist May Reduce Hyperglycemia, Glycosuria in Diabetes Due to Hyperglycemia Occurs with Severe Hemolytic Anemia By ↑ Oxidation of Ketone Bodies in Diabetics Acidotic Response Especially in Children May Cause Nephrotoxicity Initial Effect Always, May Persist Conjugate May React with Benedict's (M) Occurs with Poisoning Interferes with Fluoro-, Colorimetric Procedures (M) ↓ Renal Tubular Reabsorption Affects Renal Elimination Conjugate Inhibits B-Glucuronidase, Dose > 4.8g/day (M) Prolonged Administration Decreases Concentration in Buffy Coat Turbidity < Globulins With Sulfosalicylic Acid (M) If High (M) Placental Alkaline Phosphatase if From Pitman-Moore or Parke-Davis Causes Effect if Iodinated Bone Marrow Depression With Hemolytic Anemia Bone Marrow Depression With Hemolytic Anemia Bone Marrow Depression With Hemolytic Anemia Bone Marrow Depression With Hemolytic Anemia Melena and Hemorrhagic Gastroenteritis Occurs in High Percentage of Patients Due to Hepatocellular Dysfunction May Cause Hepatocellular Dysfunction Due to Hepatocellular Dysfunction SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Antibiotics Anticoagulants Ascorbic Acid Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Fecal Plasma Urine Whole Blood Fecal Plasma Fecal Plasma Serum Cephalin Flocculation ↑ Creatine Phosphokinase ↑ Creatinine ↑ Isocitric Dehydrogenase ↑ Magnesium ↓ Non Protein Nitrogen ↑ Potassium ↓ Potassium ↑ SGOT↑ SGPT ↑ Sodium ↓ Thymol Turbidity ↑ Urea Nitrogen ↑ Creatinine Clearance ↓ Glomerular Filtration Rate ↓ Magnesium ↑ Myoglobin ↑ Protein ↑ UA Bile ↑ UA Casts ↑ UA Hemoglobin ↑ UA Protein ↑ UA RBC/ High Power Field ↑ Urobilinogen ↓ Prothrombin Time ↑ Urobilinogen ↓ Coagulation Time ↑ Color ↑ Prothrombin Time ↑ Occult Blood Negative Catecholamines ↑ Bilirubin ↑ Serum Serum Serum Serum Serum Serum Serum Cholesterol ↓ Cholesterol ↑ Creatinine ↑ Glucose ↓ Glucose ↑ Glucose ↑ Lactic Dehydrogenase ↓ Due to Hepatocellular Dysfunction Rhabdomyolysis Cause by Severe Hypokalemia Nephrotoxic Effect Due to Hepatocellular Dysfunction (Occasional) Associated with Toxic Effect of Drug Nephrotoxic Effect (Frequent) Associated with Renal Damage May Occur with Renal Toxicity Hepatotoxicity Reported Hepatotoxicity Reported Significant Effect Even in Normal Subjects Due to Hepatocellular Dysfunction Nephrotoxic Effect Nephrotoxicity Effect (Up to 39%) Occurs in High Percentage of Patients Following IV Infusion for 2 Hours Caused by Rhabdomyolysis Nephrotoxic Effect Reported Hepatotoxicity Granular and Hyaline Casts with Toxicity Nephrotoxicity, Bleeding Actually Caused by Drug Nephrotoxicity Nephrotoxicity Inhibit G.I. Tract Flora ↓ Synthesis of Vitamin K by G.I. Tract Inhibit G.I. Tract Flora Therapeutic Intent Red to Black Due to Internal Bleeding Therapeutic Intent Interferes with Analytic Methods (M) Concentrated Solutions Cause Striking Fluorescence (M) At Therapeutic Concentration May Affect Sequential Multiple Analyzer 12/60 Method (M) Tends to Fall in People Under 25 When 1g/ Day Given When Atherosclerotic, Possible/ Unknown Mobilization From Arteries Chromogenicity in Color Reaction (Acts as Reducing Agent) (M) Slight Effect With Coupled Glucose Oxidase Method (M) At 1 mmol/L Affects Sequential Multiple Analyzer 12/60 Method (M) Affects Alkaline Perricyanide Methods (M) At Therapeutic Concentration May Depress Sequential Multiple SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Serum Serum Serum Serum Serum Obtained During Test Conditions Urine Urine Atropine Bacitracin Bisacodyl Calcium Chloride Calcium Gluconate Chloral Hydrate Urine Urine Urine Urine Urine Urine Urine Whole Blood Other Bodily Fluid Serum Serum Urine Urine Serum Urine Urine Urine Urine Urine Fecal Serum Whole Blood Serum Urine Urine Plasma Plasma Serum Urine Phenylalanine ↓ SGOT↑ Triglycerides ↓ Tyrosine ↓ Uric Acid ↑ Protein ↑ Analyzer 12/60 Value (M) Reduces Elevated Level of Premature Infants At 1 mmol/L Affects Sequential Multiple Analyzer 12/60 Method (M) Effect Observed in Atherosclerotic Patients Reduces Elevated Level of Premature Infants Measured as Reducing Substance (M) Reacts With Folin-Ciocalteu of Lowry Procedure (M) Creatine ↑ Glucose ↓ Acts as Reducing Agent (M) Impaired Color Development of Chromogen in Glucose Oxidase Method (M) Porphobilinogen ↓ Inhibition of Color Develop if No Prior Separation (M) Sugar ↑ False + With Benedict's and Clinitest (M) Uric Acid ↑ Measured as Reducing Substance (M) UA Glucose ↓ May Inhibit Testapea and Clinistix (M) UA Hemoglobin ↓ In Large Amounts Inhibits Guaic Test (M) Urobilinogen ↓ Lowered pH Reduces Excretion 17 Hydroxy Corticosteroids ↑ Interferes With Method of Reddy (M) White Cell Count ↑ May Cause Leukocytosis (In Children) Gastric Juice Hydrochloric Acid ↓ Volume Also Reduced Barbiturate ↑ False + Screen Test with Mercury Complex Form Glucose ↓ Possible Slight Fall if Given as Premedication Phenolsulfonphthalein Excretion ↓ Interferes With Secretion by Tubules Volume ↓ Very Large Doses Cause Release of Antidiuretic Hormone Urea Nitrogen ↑ Renal Toxicity (Especially if Given IV) Protein ↑ May Cause Nephrotoxicity UA Casts ↑ Nephrotoxic Effect (Cylindruria May Occur) UA Hemoglobin ↑ Actual Bleeding Caused by Drug UA Protein ↑ Nephrotoxic Effect UA RBC/ High Power Field ↑ Actual Bleeding Caused by Drug Fat ↑ May Cause Steatorrhea if Protracted Ingestion Potassium ↓ Associated with Steatorrhea if Used in Excess pH ↓ Acidifying Salt Magnesium ↓ False ↓ if Measured by Titan-Yellow (M) Magnesium ↓ False ↓ if Measured by Titan-Yellow (M) 17 Hydroxy Corticosteroids ↓ Reduced Value Reported in a Single Case (M) Prothrombin Time ↓ Accelerates Rate of Inactivation of Coumarins Prothrombin Time ↑ Displaces Anticoagulants From Albumin Urea Nitrogen ↑ Reacts with Nessler Reaction (M) Catecholamines ↑ Interferes with Fluorometric Procedures (M) SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Chlorpromazine Urine Urine Urine Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Cerebrospinal Fluid Fecal Plasma Plasma Plasma Plasma Plasma Plasma Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum ODTC Urine Urine Porphyrins ↑ UA Sugar ↑ 17 Hydroxy Corticosteroids ↑ Eosinophils ↑ Hematocrit ↓ Hemoglobin ↓ Monocytes ↑ Platelet Count ↓ Red Cell Count ↓ White Cell Count ↓ Protein ↑ Urobilinogen ↓ Catecholamines ↑ Effective Renal Plasma Flow ↑ Growth Hormone ↓ Norepinephrine ↑ Prolactin ↑ Prothrombin Time ↑ Alkaline Phosphatase ↑ Beta-Glucuronidase ↑ Bilirubin ↑ Bromosulfophthalein Retention ↑ Cholesterol ↑ Coombs Test + Creatine Phosphokinase ↑ Direct Bilirubin ↑ Glucose ↑ Glucose Tolerance ↓ Haptoglobin ↓ Isocitric Dehydrogenase ↑ Protein-Bound Iodine ↓ Phospholipids ↑ SGOT↑ SGPT ↑ Thyroxine (T4) ↓ Uric Acid ↓ Vitamin B12 ↓ Urea Nitrogen ↑ Estrogens ↑ Gonadotropins ↓ May Precipitate Attack of Acute Porphyria Excreted as Glucuronide, Reduces Benedict's (M) Interferes with Porter-Silber Reaction (M) Often Precursor of Jaundice Hemolytic Anemia Hemolytic Anemia Occasionally Before Agranulocytosis Associated with Purpura and Pancytopenia Hemolytic Anemia Agranulocytosis/Leukopenia/Granulocytopenia Reacts as if Phenol with Folin-Ciocalteu Reagent (M) Pale Stools, Due to Cholestasis ↑ Metabolism, ↓ Organ Uptake of Norepinephrine Slight ↑ in Renal Blood Flow Probably Inhibits Secretion of Pituitary Growth Hormone ↑ Metabolism, ↓ Organ Uptake Marked ↑ in Normal in 2 Hours Associated with Failure of Excretion of Bile Salts Hepatic Sensitivity to Drug (In Up to 2% of Patients) Result of Toxic Hepatitis Sensitivity Reaction (May Cause Jaundice in Infant) Induces Transient Cholestatic Hepatitis (1 Case) Associated with Hepatocanalicular Cholestatic Jaundice Immunological Response to Drug May be Due to Injection Only (Occurs in 20%) Sensitivity Reaction to Drug (In Up To 2% of Patients) Abnormally High with Repeated Doses Abnormal Curves in 40% of Patients Hemolytic Anemia May be Hypersensitive Reaction Mechanism Obscure (Observed if Over 600mg Given) May Cause Xanthomatous Biliary Cirrhosis Hepatic Sensitivity to Drug (In Up to 2% of Patients) May be Damage of Biliary Canaliculi Increased Metabolism by Hepatic Microsomes Uricosuric Action Within 2-3 Days Possible Inhibition Effect on Some Strains of E. Gracilis (M) Produces Turbidity with Berthelot's Reagent (M) Blocks Ovulation, Maintains Decidual Reaction Blocks Ovulation, Maintains Decidual Reaction SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Clindamycin Copper Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Urine Metanephrines Total ↑ Phenylketones + Porphobilinogen ↑ Pregnancy Tests + Progestins ↓ Uric Acid ↑ UA Bile ↑ UA Protein ↑ Urobilinogen ↓ Urobilinogen ↑ Vanillylmandelic Acid ↑ Volume ↑ 17 Ketogenic Steroids ↑ 17 Ketosteroids ↓ Urine Urine Urine 17 Ketosteroids ↑ 17 Ketosteroids ↑ 17 Hydroxy Corticosteroids ↓ Urine Urine Whole Blood Whole Blood Serum Serum Serum Serum Whole Blood Whole Blood Whole Blood Whole Blood Erythrocyte Erythrocyte Erythrocyte Erythrocyte Erythrocyte Erythrocyte Erythrocyte 17 Hydroxy Corticosteroids ↑ 5 Hydroxy Indoleacetic Acid ↓ Eosinophils ↑ White Cell Count ↓ Alkaline Phosphatase ↑ Bilirubin ↑ SGOT↑ SGPT ↑ Hematocrit ↓ Hemoglobin ↓ Methemoglobin ↓ White Cell Count ↑ G6PD ↓ Hexokinase ↓ Phosphofructokinase ↓ Phosphoglyceric Kinase ↓ Pyruvate Kinase ↓ Reduced Glutathione ↓ 6-Phosphoglycerate Dehydrogenase ↓ Hemoglobin ↑ Plasma Interference in Pisano Procedure (M) Light Purple with Ferric Chloride, Same with Phenistix (M) Reacts with Ehrlich's Aldehyde Reagent (M) Gives False + with Frog, Rabbit and Immunology Test (M) Blocks Ovulation, Maintains Decidual Reaction Uricosuric Action Reported Alleged Interference with Bili-Labstix (M) Affects Turbidity Tests For Up to 3 Days (M) May be Cholestasis Reacts with Ehrlich's Aldehyde Reagent (M) ↑ Metabolism and ↓ Organ Uptake of Norepinephrine Depresses Antidiuretic Hormone Secretion or Water Reabsorption Interferes with Zimmerman Reaction (M) Inhibition of Hypothalamus and ↓ Adrenocorticotropic Hormone Secretion Interferes with Zimmerman Reaction (M) Alters Steroid Metabolism Inhibition of Hypothalamus and ↓ Adrenocorticotropic Hormone Secretion Interferes with Porter-Silber Reaction (M) Interferes with Method of Goldenberg (M) Occasional Allergic Response May Cause Agranulocytosis Transient Abnormality Noted Occurs Especially if Preexisting Liver Disease Transient Abnormality Noted Mild Transient Rises Seen With Hemolysis of Copper Toxicity May be Marked Decrease May Occur with Copper Toxicity Leukocytosis Observed with Poisoning Strongly Inhibited (No Activity at 100UM) in Vitro Very Sensitive to Inhibition by Copper in Vitro Severely Affected in Vitro Less Marked Inhibition in Vitro Severely Affected in Vitro Marked ↓ with Hemolysis of Toxicity Strongly Inhibited by Addition of Copper May Occur with Hemolysis of Toxicity SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Plasma Serum Serum Serum Serum Serum Diazepam Digoxin Diphenhydramine Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Whole Blood Whole Blood ODTC ODTC Serum Serum Serum Serum Erythrocyte Erythrocyte Erythrocyte Urine Urine Whole Blood Whole Blood Whole Blood Plasma Serum Serum Methemoglobin ↑ Acid Phosphatase Total ↓ Arginase ↑ Bilirubin ↑ Bromosulfophthalein Retention ↑ Calcium ↑ Occurs with Acute Intravascular Hemolysis Cupric Ions Inhibit Red Cell Enzyme (M) Increased when Hemolytic Crisis Occurs Marked ↑ with Hemolysis of Toxicity ↑ with Hemolytic Crisis Interferes with Ethylenediaminetetraacetic Acid Titration Procedures (M) Cephalin Flocculation ↑ Transient Effect in Poisoning Ceruloplasmin ↑ Observed with Copper Poisoning Copper ↑ May be Normal in Toxic Cases with Hemolysis Haptoglobin ↓ May be Hemolysis with Poisoning Lactic Dehydrogenase ↑ Toxic Effect, Sharp ↑ with Hemolytic Crisis Protein-Bound Iodine ↓ As Contaminant of Water May Affect Analysis (M) SGOT↑ Toxic Effect, Sharp ↑ with Hemolytic Crisis SGPT ↑ Toxic Effect, Sharp ↑ with Hemolytic Crisis Sodium ↑ May Interfere with Flame Photometry (M) Copper ↑ Observed with Poisoning UA Color ↑ Blue Diapers (Alkaline Urine on Copper Fastenings) (M) UA Hemoglobin ↑ False + with Guaiac and Benzidine Tests (M) UA Hemoglobin ↑ May Occur with Copper Toxicity Neutrophils ↓ Transitory Neutropenia Reported White Cell Count ↓ Leukopenia Gastric Juice Hydrochloric Acid ↓ Presumed Central Action Lasts for 5 Hours After 10mg Gastric Juice Volume ↓ Presumed Central Action Lasts for 5 Hours After 10mg Bilirubin ↑ Presumed Hepatic Toxic Effect Iodine 131 Uptake ↓ Conflicting Reports, Unknown Effect Triiodothyronine Uptake ↓ Resin Test Affected Dihydroxyphenylalanine Very Slight Purple Color Produced (M) Screen Test + Potassium ↓ 6% Drop Within 2 Days, Affects Membrane ATP-ASZ Sodium ↑ 16% ↑, Due to Effect on Membrane ATP-ASE Water ↑ Slight Effect Only Due to Action on Membrane 17 Ketosteroids ↓ Slight Effect on Zimmerman Reaction in Vitro (M) 17 Hydroxy Corticosteroids ↑ Moderate Effect with in Vitro Test (M) Hematocrit ↓ Hemolytic Anemia Hemoglobin ↓ Hemolytic Anemia Red Cell Count ↓ Hemolytic Anemia Ammonia ↓ Reported Effect in Exogenous NH3 Toxicity Bilirubin ↑ May Occur with Hemolytic Anemia Haptoglobin ↓ May Occur with Hemolytic Anemia SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Dopamine Fentanyl Fibrin Hydrolysate Fluorescein Furosemide Glucose Urine Plasma Plasma Serum Whole Blood Plasma Serum Urine Urine Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Plasma Plasma Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Urine Urine Whole Blood Plasma Plasma Plasma Serum Serum Serum Sodium ↑ Epinephrine ↑ Norepinephrine ↓ Amylase ↑ Hemoglobin ↓ Ammonia ↑ Phosphate ↓ UA Color ↑ Urobilin ↑ Hematocrit ↓ Hemoglobin ↓ Platelet Count ↓ Red Cell Count ↓ White Cell Count ↓ Ammonia ↑ Insulin ↓ Amylase ↑ Calcium ↓ Chloride ↓ Glucose ↑ Glucose Tolerance ↓ Potassium ↓ Sodium ↓ Urea Nitrogen ↑ Uric Acid ↑ Calcium ↑ Chloride ↑ Glomerular Filtration Rate ↓ Glucose ↑ Potassium ↑ Sodium ↑ UA Glucose ↑ Volume ↑ Sedimentation Rate ↓ Ammonia ↑ Growth Hormone ↑ Insulin ↑ Alanine ↑ Amino Acids ↓ Arginine ↓ Diuretic Effect Mechanism Obscure Mechanism Obscure May Cause Spasm of Sphincter of Oddi Possibly Due to Septicemia or Hypophosphatemia Due to High Ammonia Content of Solution Intracellular Transfer I.V. Administration May Cause Yellow-Orange Color Produces Yellow-Green Fluorescence May Cause Anemia May Cause Anemia May Be Associated with Purpura May Cause Anemia May Cause Leukopenia or Aplastic Anemia Acts Like Thiazides Causes Hypokalemia & Alkalosis I.V. Injection Effect, Little on Blood Sugar May Induce Mild Pancreatitis Diuretic Action (Different Effect Hydrochlorothiazide) Diuretic Action (Inhibits Tubular Reabsorption) Diabetogenic-Like Action of Drug: Affects GTT Diabetogenic-Like Action of Drug Diuretic Action Diuretic Action with Sodium Depletion Possible Nephrotoxic Effect (Reversible) Usually Dehydration ↓ Urate Clearance Impaired Reabsorption (Initial Effect Only) Diuretic Action Excessive Diuresis May Cause Effect Diabetogenic-Like Action of Drug Diuretic Action Diuretic Action Due to Hyperglycemia Diuretic Action High Blood Sugar Lowers Sedimentation Rate (M) May ↑ as Glucose ↑ in Cirrhotics Delayed Rise After Initial Slight Fall Marked Rise Immediately After Oral or I.V. Administration Rise Related to Gluconeogenesis After Load (Some Affected Only) - Deposited in Muscle Probable Muscle Uptake SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Haloperidol Heparin Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Urine Urine Whole Blood Whole Blood Whole Blood Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Whole Blood Whole Blood Calcium ↓ Chloride ↓ Creatinine ↑ Isoleucine ↓ Leucine ↓ Non Esterified Fatty Acids ↓ Non Esterified Fatty Acids ↑ Osmolality ↑ Phenylalanine ↓ Phosphate ↓ Potassium ↓ Threonine ↓ Urea Nitrogen ↓ Uric Acid ↓ Uric Acid ↑ Valine ↓ Estriol ↓ Insulin ↑ Osmolality ↑ Potassium ↓ Uric Acid ↑ Xylose Excretion ↑ 17 Ketogenic Steroids ↓ 17 Ketosteroids ↓ Red Cell Count ↓ White Cell Count ↓ White Cell Count ↑ Alkaline Phosphatase ↑ Bilirubin ↑ Bromosulfophthalein Retention ↑ Cephalin Flocculation ↑ Cholesterol ↓ Desmosterol ↑ Glucose ↓ SGOT↑ SGPT ↑ Thymol Turbidity ↑ UA Bile ↑ Clotting Time ↑ Factor IX ↓ May Fall by 0.5 meq/L During GTT Dilutional Effect When Infused Interferes with Jaffe Reaction (M) Probable Muscle Uptake Probable Muscle Uptake Effect Greater in Normal Than in Diabetics Delayed Rise 3 Hours After Administration Osmotically Active Constituent in Samples (M) Probable Muscle Uptake During GTT, Less Marked and Longer Than Calcium Shift Intracellularly When Infusion Given Probable Muscle Uptake Protein Sparing Effect of Glucose and Hemodilution ↑ Urate Clearance Also Seen in Diabetics Reducing Substance Reacts with Phosphotungstate (M) Probable Muscle Uptake Interference with Gas Liquid Chromatography Method (M) Occurs 3 Hours After Glucose Load Osmotically Active Constituent in Samples (M) After Oral Glucose and Fall in Serum Concentration Infusions Have Uricosuric Action Interferes with Bromoaniline Procedure if Over 2g/100mL (M) Interferes with Norymberski Reaction (M) Interferes with Zimmerman Reaction (M) May Cause Anemia May Cause Anemia Rarely Reported Leukocytosis May Cause Hepatocellular Changes May Cause Hepatocellular Changes May Cause Hepatocellular Changes May Cause Hepatocellular Changes Inhibits Cholesterol Biosynthesis Further Metabolism Inhibited SO Accumulates Insulin Like Action of Drug Reported in One Case May Cause Hepatocellular Changes May Cause Hepatocellular Changes May Cause Hepatocellular Changes May Cause Hepatocellular Changes Concentration Related Effect Reported Effect SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Hydroxyzine Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Plasma Plasma Plasma Plasma Plasma Plasma Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Plasma Factor V ↓ Factor XI ↓ Platelet Count ↓ Partial Thromboplastin Time ↑ Thrombin Time ↑ Thromboplastin Gen ↓ Ammonia ↑ Corticosteroids ↑ Insulin ↓ Insulin ↑ Prothrombin Time ↑ Thyroid Stimulating Hormone ↓ Albumin ↑ Bromosulfophthalein Retention ↑ Calcium ↓ Calcium ↑ Cholesterol ↓ Cholesterol ↑ Creatine Phosphokinase ↓ Free Thyroxine ↑ Glucose ↑ Hydroxybutyric Dehydrogenase ↓ Lipoprotein Electrophor + Lipoprotein Lipase ↑ Non Esterified Fatty Acids ↑ Phosphate ↑ Potassium ↑ Prebeta-Lipoproteins ↓ Sodium ↓ Sodium ↑ Thymol Turbidity ↑ Thyroxine (T4) ↓ Triglycerides ↓ Triiodothyronine (T3) ↑ Triiodothyronine (T3) Uptake ↑ Zinc Sulfate Turbidity ↑ Aldosterone ↓ Sodium ↑ 5 Hydroxy Indoleacetic Acid ↓ Prothrombin Time ↑ Concentration Related Effect Concentration Related Effect Reported Effect Following IV Infusions Concentration Related Effect Related to Concentration of Circulating Heparin Abnormal Response (Inhibition) Contains Variable Amounts of Ammonium Salts (M) If Contaminated by Impurities (M) Effect in Heparinized Plasma and Serum (M) Spuriously High Values Reported For Immunoassay (M) Concentration Related Effect Interferes with Thyroxine Binding to Protein Promotes Binding of Haba Dye to Globulins (M) Color Intensity ↑ in Serum, Wavelength Shifted (M) Interferes with EDTA and Fluorometric Methods (M) If Calcium Salt Used May Affect Result (M) Mechanism Not Detailed Rebound Effect of Cessation of Treatment Reported Effect (M) Probable Modification of Thyroxine Binding Single Report of Rise of 30 mg/ 100 mL Significant Inactivation (M) Alters Electrophoretic Pattern (M) Release of Tissue Lipase Into Plasma Also Occurs with Situational Stresses Phosphate Contamination of Heparin Reported (M) ↓ Renal Excretion Non-Sustained Response to Small IV Injection ↑ Excretion Due to Aldosterone Suppression If Sodium Salt Used May Affect Result (M) Affects Physico-Chem Properties Altering Turbidity (M) Probable Modification of Thyroxine Binding Prompt ↓ When Small Dose Given IV Interferes with Thyroxine Binding to Protein Red Cell Uptake ↑, Resin Unaffected Affects Physico-Chem Properties (M) Suppressed Secretion with Protracted Treatment Due to Aldosterone Suppression Reduction in Single Case Carcinoid Syndrome Prolongs Action of Anticoagulants SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Insulin Lactobacillus Lidocaine Mafenide Magnesium Salts Mannitol Urine Urine Urine Plasma Plasma Plasma Plasma Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Plasma Cerebrospinal Fluid Whole Blood Whole Blood Whole Blood Whole Blood Urine Urine Urine Urine Urine Urine Serum Serum Serum 17 Ketogenic Steroids ↑ 17 Hydroxy Corticosteroids ↑ 17 Hydroxy Corticosteroids ↑ Alpha Amino Nitrogen ↓ Corticosteroids ↑ Corticotrophin ↑ Epinephrine ↑ Cholesterol ↓ Creatine Phosphokinase ↑ Glucose ↓ Magnesium ↓ Non Esterified Fatty Acids ↓ Protein-Bound Iodine ↑ Phosphate ↓ Potassium ↓ Protein ↑ Thymol Turbidity ↑ Amino Acids ↓ Amino Acids ↑ UA Ketones ↑ Vanillylmandelic Acid ↑ Ammonia ↓ Protein ↑ PCO2 ↓ pH ↓ pH ↑ White Cell Count ↓ Ammonia ↓ Bicarbonate ↑ Chloride ↓ pH ↑ Potassium ↑ UA pH ↑ Alkaline Phosphatase ↑ Calcium ↓ Calcium ↑ Serum Urine Serum Magnesium ↑ Diagnex Blue Excretion ↑ Chloride ↓ Interferes with Zimmerman Reaction (M) Affects Modified Glenn-Nelson Method Interferes with Porter-Silber Reaction (M) ↑ Uptake by Tissues Significant Effect at 40 Minutes, Maximal at 60 Minutes Response to Stress Stimulation of Adrenal Medulla, Possible by Hypoglycemia Therapeutic Goal Is an Activator of Enzyme Natural Action of Hormone Effect Seen in Treatment of Diabetic Coma Effect Similar in Normal and Diabetics Mechanism Obscure Increased Phosphorylation of Glucose Therapeutic Effect, Causes Intracellular Shift Associated with Increased Protein Synthesis Associated with Increased Protein Synthesis Metabolic Effects Metabolic Effects Occurs Especially if low Liver Glycogen Stores ↑ After Insulin Shock, None with Normal Dose Causes Reduction in Hepatic Reacts with Folin-Ciocalteu Reagent (M) Inhibition of Carbonic Anhydrase When Applied Topically If Respiratory Impairment as Reduced Renal Buffering Usual Finding with Respiratory Alkalosis Probable Effect Observed in One Child Inhibition of Carbonic Anhydrase When Applied Topically Inhibition of Carbonic Anhydrase When Applied Topically Selective Retention Inhibition of Carbonic Anhydrase When Applied Topically Inhibition of Carbonic Anhydrase When Applied Topically Inhibition of Carbonic Anhydrase When Applied Topically Activators of Enzyme in Laboratory Procedures (M) Competes with Calcium for GI Tract Absorption Measured as Calcium in Some Ethylenediaminetetraacetic Acid Procedures (M) Absorbed From GI Tract From Antacids Heavy Metal Displacement of Diagnex Blue Effect if Marked Diuresis SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Methadone Metronidazole Mineral Oil Nafcillin Nicotine Nitrofurantoin Serum Serum Serum Serum Serum Serum Serum Urine Whole Blood Serum Whole Blood Whole Blood Urine Urine Plasma Serum Serum Serum Plasma Serum Serum Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Serum Serum Serum Serum Serum Serum Serum Serum Serum Serum Creatinine ↑ Osmolality ↑ Phosphate ↓ Potassium ↑ Sodium ↓ Sodium ↑ Uric Acid ↓ Sodium ↑ PCO2 ↑ Bromosulfophthalein Retention ↑ Neutrophils ↓ White Cell Count ↓ UA Color ↑ 17 Ketogenic Steroids ↓ Prothrombin Time ↑ Carotene ↓ Bromosulfophthalein Retention ↑ SGOT↑ 11 Hydroxy Corticosteroids ↑ Glucose ↑ Non Esterified Fatty Acids ↑ Eosinophils ↑ Heinz-Body Formation + Hematocrit ↓ Hemoglobin ↓ Mean Corpuscular Volume ↓ Methemoglobin ↑ Platelet Count ↓ Red Cell Count ↓ White Cell Count ↓ Alkaline Phosphatase ↑ Bilirubin ↑ BSP Retention ↑ Cephalin Flocculation ↑ CO2 Content ↓ Creatinine ↑ Glucose Tolerance ↓ Haptoglobin ↓ Lactic Dehydrogenase ↑ Non Protein Nitrogen ↑ Due to Dehydration May Cause Marked Dehydration Inhibition of Color Development (M) Mechanism Not Detailed Effect if Marked Diuresis May Cause Marked Dehydration Reported to Have Uricosuric Action Slight Increase Occurs Only May Cause Diminished Pulmonary Ventilation Hepatotoxic Effect or Spasm of Sphincter of Oddi Transient Neutropenia May Occur Leukopenia and Reduction of Polymorphs Brown Color Probably Due to Metabolite (M) If Previously Elevated, Possibly Depresses Adrenal Cortex Inhibits Absorption of Vitamin K Reduced Absorption (May be 50% Normal) Reported Effect (Possibly Hepatotoxicity) Possibly Due to Trauma of Injection Up To 80% ↑ After Heavy Smoking Due to Adrenal Response in Poisoning Probable Stress Response Allergic Response (Greater Than 1%) May Cause Hemolytic Anemia Megaloblastic Anemia/Hypersensitivity (G6PD) Megaloblastic Anemia/Hypersensitivity (G6PD) Megaloblastic Anemia/Hypersensitivity (G6PD) May Cause Hemolysis with G6PD Deficiency Thrombocytopenia Hypersensitivity (G6PD)/ Megaloblastic Anemia Leukopenia/ Agranulocytosis May Occur May Cause Cholestatic Jaundice May Cause Hemolytic Anemia of Cholestasis Intrahepatic Cholestatic Jaundice May be Cholestatic Jaundice Nephrotoxicity May Cause Azotemia Nephrotoxic Effect Single Case Reported Hemolytic Effect May Cause Hemolytic Anemia Nephrotoxic Effect SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Nystatin Oxandrolone Phenols Phytonadione Potassium Potassium Chlorate Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Whole Blood Whole Blood Plasma Plasma Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Urine Whole Blood Whole Blood Whole Blood Plasma Serum Urine Urine Plasma Serum Serum Whole Blood Serum SGOT↑ SGPT ↑ Thymol Turbidity ↑ Urea Nitrogen ↑ 5-Nucleotidase ↑ Alkaline Phosphatase ↓ Lactic Dehydrogenase ↓ Sugar ↑ UA Bile ↑ UA Color ↑ Urobilinogen ↑ Eosinophils ↑ Platelet Count ↓ Fibrinogen ↑ Plasminogen ↑ Bromosulfophthalein Retention ↑ Cholesterol ↓ Glucose ↓ Haptoglobin ↑ Sialic Acid ↑ Triglycerides ↓ Phenylketones + UA Casts ↑ UA Color ↑ UA Hemoglobin ↑ UA Protein ↑ UA RBC/ High Power Field ↑ UA Sugar ↑ Hematocrit ↓ Hemoglobin ↓ Red Cell Count ↓ Prothrombin Time ↓ Bilirubin ↑ UA Hemoglobin ↑ UA RBC/ High Power Field ↑ Ammonia ↓ Calcium ↑ Sodium ↑ Methemoglobin ↑ Chloride ↑ May Cause Cholestatic Jaundice May Cause Cholestatic Jaundice May Be Cholestatic Jaundice Possible ↓ in Already Impaired Renal Function Due to Cholestasis Interference with Determination Method (M) Interference with Determination Method (M) Metabolites May Reduce Benedict's, Yield False + (M) May Cause Cholestatic Jaundice Brown, Yellow Color (M) Intrahepatic Cholestatic Jaundice May Cause Allergic Reaction Thrombocytopenia (AMA-Blood Dyscrasias) Metabolic Effect Metabolic Effect Slight ↑ in One Child Anabolic Effect Anabolic Effect Metabolic Effect Metabolic Effect ↑ Triglyceride Hydrolysis Peripherally Violet with Ferric Chloride, Nil With Phenistix (M) Nephrotoxicity With Poisoning (Usually RBC Casts) Dark Green to Brownish Black on Standing (M) Nephrotoxicity With Poisoning Nephrotoxicity With Poisoning Occur With Renal Damage of Poisoning Interferes With Benedict’s Reagent Hemolysis May Occur with G6PD Deficiency Hemolysis May Occur with G6PD Deficiency Hemolysis May Occur with G6PD Deficiency Stimulates Synthesis of Clotting Factors Large Dose Effect, or with G6PD Deficiency Actual Bleeding Caused by Drug Actual Bleeding Caused by Drug Potassium Repletion in Hepatic Coma May Reduce Ammonia Affects Flame Photometry if Poor Instrument (M) Affects Flame Photometry if Poor Instrument (M) May Cause Hemolytic Anemia Added Chloride SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Prednisolone Serum Serum Whole Blood Whole Blood Serum Glucose ↓ Potassium ↑ White Cell Count ↓ White Cell Count ↑ Protein-Bound Iodine ↓ Drawn Into Cells with Potassium Over Correction of Hypokalemia Leukopenia Leukocytosis Observed Occasionally Inhibits Iodination of Tyrosine Residues in Thyroxine Binding Serum Serum Urine Whole Blood Fecal Plasma Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Urine Urine Urine Urine Urine Urine Whole Blood Plasma Serum Serum Serum Serum Serum Serum Serum Serum Urine Urine Potassium ↓ Sodium ↑ Potassium ↑ White Cell Count ↓ Urobilinogen ↓ Prothrombin Time ↑ Alkaline Phosphatase ↑ Bilirubin ↑ Bromosulfophthalein Retention ↑ Cephalin Flocculation ↑ Cholesterol ↑ SGOT↑ SGPT ↑ Thymol Turbidity ↑ Catecholamines ↑ Metanephrines Total ↑ Phenylketones + UA Bile ↑ Urobilinogen ↓ Vanillylmandelic Acid ↑ 17 Hydroxy Corticosteroids ↑ 5 Hydroxy Indoleacetic Acid ↓ White Cell Count ↓ Catecholamines ↑ Alkaline Phosphatase ↑ Bilirubin ↑ Bromosulfophthalein Retention ↑ Cephalin Flocculation ↑ Glucose ↑ SGOT↑ SGPT ↑ Thymol Turbidity ↑ Pregnancy Tests Negative Pregnancy Tests + Slight Mineralocorticoid Effect Very Slight Mineralocorticoid Effect Slight Mineralocorticoid Effect Agranulocytosis Due to Interference in Development Pale Stools Associated with Cholestasis Associated with Impaired Excretion of Bile Salts Cholestatic Effect Cholestatic Effect Cholestatic Effect Cholestatic Effect Cholestatic Effect Cholestatic Effect Cholestatic Effect Cholestatic Effect ↑ Metabolism, ↓ Organ Uptake of Norepinephrine ↑ Metabolism, ↓ Organ Uptake of Norepinephrine Light Purple with Ferric Chloride, Same with Phenistix (M) Cholestatic Effect Cholestatic Effect ↑ Metabolism, ↓ Organ Uptake of Norepinephrine Interferes with Porter-Silber Reaction (M) Interference with Nitrosonaphthol Methods Agranulocytosis/ Leukopenia ↑ Metabolism, ↓ Organ Uptake of Norepinephrine May Cause Cholestasis May Cause Cholestasis May Cause Cholestasis May Cause Cholestasis If Given I.V. or I.M. May Cause Cholestasis May Cause Cholestasis May Cause Cholestasis False Negative with Porter-Silber Reaction (M) False + with Gravindex (M) Globulin Prochlorperazine Promethazine SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Silver Sodium Sodium Bicarbonate Sodium Chloride Trimethoprim Vancomycin Vitamin A Urine Urine Urine Whole Blood Fecal Serum Serum Serum Whole Blood Serum Serum Urine Urine Urine Serum Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Serum Whole Blood Whole Blood Serum Urine Urine Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Whole Blood Plasma Serum Serum Serum Serum UA Bile ↑ 17 Hydroxy Corticosteroids ↑ 5 Hydroxy Indoleacetic Acid ↓ pH ↑ Occult Blood + Chloride ↓ Sodium ↓ Potassium ↑ pH ↑ Potassium ↓ Sodium ↑ pH ↑ UA Protein ↑ Urobilinogen ↑ Bilirubin ↓ Hematocrit ↓ Hemoglobin ↓ Mean Corpuscular Volume ↑ Platelet Count ↓ Red Cell Count ↓ Sedimentation Rate ↓ Folate ↓ Eosinophils ↑ White Cell Count ↑ Urea Nitrogen ↑ Protein ↑ UA Protein ↑ Hematocrit ↓ Hemoglobin ↓ Methemoglobin ↑ Neutrophils ↓ Red Cell Count ↓ Sedimentation Rate ↑ White Cell Count ↓ Prothrombin Time ↑ Bilirubin ↑ Cholesterol ↑ Direct Bilirubin ↑ Iodine 131 Uptake ↓ May Cause Cholestasis Interference With Porter-Silber Reaction (M) Interference with Nitrosonaphthol Methods (M) Observed After Silver Nitrate Antiseptics May Cause Hemorrhagic Gastroenteritis Observed After Silver Nitrate Antiseptics Observed After Silver Nitrate Antiseptics Variable Concentration Affects Most Flame Methods Affects Acid-Base Balance in Vivo Causes Potassium to Shift Into Cells May Cause Sodium Retention Used to Alkalinize Urine False + with Labstix Due to High pH (M) ↑ Clearance When Urine is Alkaline Inhibition of Diazo Test Reported (M) Folic Acid Antagonist Possible Megaloblastic Anemia Folic Acid Antagonist Possible Megaloblastic Anemia Occurs With Megaloblastic Anemia Most Common Serious Toxic Effect Folic Acid Antagonist Possible Megaloblastic Anemia With Sulfa Caused Marked ↓ in Rheumatoids Usually with Sulfa - No Hematological Abnormality Allergic Response Due to Eosinophilia Nephrotoxic Effect (May be Fatal) Nephrotoxicity May Occur Nephrotoxicity May Occur Anemia Observed Anemia Observed May Cause Hemolysis with G6PD Leukopenia with Hypoplastic Anemia Reported With Excessive Doses and Use Observed Effect with Unknown Explanation Leukopenia with Hypoplastic Anemia Reported Hemorrhagic Trend Experienced if Vitamin K is Restricted Interferes with Analysis (M) Interferes with Zlatkis-Zak Reaction (M) Interferes with Analysis (M) Significant Effect When Administered for 3 Weeks SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive Serum Protein-Bound Iodine ↓ Inhibits Iodination of Tyrosine Residues in Thyroxine Binding Serum Serum Urine Serum Protein-Bound Iodine ↑ Vitamin A ↑ Magnesium ↑ Alkaline Phosphatase ↓ When Given in Cod Liver Oil Ingested Compound in Serum Measured by Fluorometric Method of Schachter (M) Inhibitors of Enzyme in Laboratory Procedures (M) Globulin Zinc Zinc Salts SGOT: Serum Glutamic-Oxalacetic Transaminase; SGPT: Serum Glutamic-Pyruvic Transaminase; UA: Urinalysis; G6PD: Glucose6-Phosphate Dehydrogenase; RBC: Red Blood Cell; ODTC: Obtained During Test Conditions; + = Positive