Drug monitoring Flashcards

1
Q

RF for statin associated myopathy

A
PMHx or FHx of muscle disorders
previous muscular toxicity
high alcohol intake
renal impairment
hypothyroidism
elderly
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2
Q

if high risk for statin associated myopathy what should be done to monitor pt?

A

baseline CK required prior to starting

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3
Q

what test should be done prior to starting vancomycin? and why?

A

creatinine

drug renally cleared - dosing altered if poor renal function prior to initiation

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4
Q

what should be checked prior to starting statins

A

LFTs

if AST or ALT 3x normal then statins are contraindicated

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5
Q

how are statins monitored?

A

3 and 12 months after starting do LFTS

monitor lipids for change

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6
Q

what is the normal range for lithium?

A

0.4-0.8 mmol/L

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7
Q

what level of lithium would you expect toxicity signs?

A

1.5 mmol/L

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8
Q

when should lithium levels be tested?

A

12 hours after last dose

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9
Q

how often should lithium levels be checked?

A

weekly after titration until stable, then 3 monthly

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10
Q

when should FBC be done during methotrexate treatment?

A

risk of blood dyscrasias

1-2 weekly until stable treatment
then 2-3 months

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11
Q

why do LFTs prior to methotrexate treatment?

A

deranged is a contraindicated

methotrexate hepatically metabolised

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12
Q

what should be monitored on olanzapine?

A

fasting blood glucose prior to starting

monitor blood glucose during treatment

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13
Q

what monitoring do women on combined OCP required?

A

annual review

in particular BP check as HTN increases risk of arterial disease associated with OCP use

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14
Q

what should be done prior to starting amiodarone treatment?

A

arrange for a baseline CXR

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15
Q

what is the peak serum concentration range for a multiple dose regimen of gentamicin?

A

3-5 mg/L

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16
Q

what is the trough serum concentration range for a multiple dose regiment of gentamicin?

A

< 1 mg/L

17
Q

what needs to be checked prior to starting digoxin treatment and then throughout?

A

renal function (serum creatinine)

renally excreted, poor renal function is RF for toxicity

18
Q

what should be monitored when on sodium valproate therapy?

A

LFT as hepatotoxic

19
Q

what monitoring is required for clozapine?

A

FBC weekly for at least first 18 weeks

20
Q

monitoring for statins

A

LFT

baseline, 3 months and 12 monthly

21
Q

monitoring for ACEi

A

U&Es
prior to treatment
after increasing dose
at least annually if on stable dose

22
Q

monitoring for amiodarone

A

TFT, LFT

TFT, LFT, U&E + CXR prior to starting
TFT, LFT every 6/12

23
Q

methotrexate monitoring

A

CXR before starting

FBC, LFT, U&E - prior to starting then weekly till stabilised then every 2-3/12

24
Q

monitoring for azathioprine

A

FBC, LFT before
FBC weekly for the first 4 weeks
FBC, LFT every 3 months