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6th Year PSA > Drug monitoring > Flashcards

Drug monitoring Flashcards

1
Q

what are risk factors for myopathy in those on statin therapy

A

RFs: personal/FHx, muscular disorders, hx of muscular toxicity, high alcohol, renal impairment, hypothyroidism, elderly

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2
Q

what to measure for statin myopathy in those with risk factors

A

CK

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3
Q

what to measure for statin myopathy in those with NO risk factors

A

ALT

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4
Q

statin monitoring

A

Check LFTs at 3 and 12m

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5
Q

When to stop taking a statin

A

stop if taking a macrolide

+ caution in CYP inducers (ZAG DEVICES)

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6
Q

when is a statin CI

A

Active liver disease, ALT/AST <3x normal

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7
Q

does phenytoin need monitoring

A

NO (only check if adjusting dose, suspected toxicity, suspected non-adherence)

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8
Q

ciclosporin monitoring

A

trough levels immediately before dose

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9
Q

lithium monitoring

A

sample 12h after last dose

  • monitor weekly after 1st dose/change until stable
  • and every 3m
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10
Q

lithium therapeutic range + toxic effects

A

therapeutic range 0.4-0.8
toxic effects >1.5
low Na+ –> higher lithium toxicity risk

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11
Q

what to use as anti-hypertensive with lithium

A

CCBs (amlodipine)
NOT ACEi, thiazides, loops
NO NSAIDs

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12
Q

methotrexate monitoring

A

FBC, U+E, LFTs every 2-2wks until stable
then FBC, U+E, LFTs every 2-3 months
usu taken ONCE A WEEK

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13
Q

when should a statin be taken

A

ONCE AT NIGHT

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14
Q

methotrexate important to tell pts

A

REPORT SORE THROATS/INFECTIONS

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15
Q

methotrexate imp CI

A

abnormal LFTs

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16
Q

how often should methotrexate be taken

A

Once a week

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17
Q

Antipsychotics Monitoring at 0m (5 things)

A
  1. ECG (if RF for CVD)
  2. Prolactin
  3. Lipids
  4. Weight
  5. BMs
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18
Q

Antipsychotics Monitoring at 1m

A
  1. Weight

5. BMs

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19
Q

Antipsychotics Monitoring at 3m

A
  1. Lipids

4. Weight

20
Q

Antipsychotics Monitoring at 6m

A
  1. Prolactin
  2. Lipids
  3. Weight
  4. BMs
21
Q

Antipsychotics Monitoring Yearly

A
  1. Prolactin
  2. Lipids
  3. Weight
  4. BMs
22
Q

OCP monitoring

A 
BP montioring (na+ retention) 
BMI monitoring
23
Q

what is the risk with OCP + HTN

A

increased arterial disease risk

24
Q

Amiodarone what 4 things to monitor at baseline

A
  1. CXR
  2. TFTs (TSH, T3,T4)
  3. LFTs
  4. K+ (commence with caution if LOW due to incr risk of arrhythmias)
25
Q

Amiodarone and renal ftn link

A

does NOT affect renal ftn
but should be adjusted to renal ftn
SO no need to check renal ftn before starting

26
Q

Carbimazole monitoring

A

FBC (neutrophils) –> agranulocytosis due to BM supression

27
Q

Gentamicin/Vancomycin IV monitor whwat 3 things

A

U&E
Auditory monitoring
Vestibular monitoring

28
Q

Gentamicin/Vancomycin IV SEs

A

renal toxicity

ototoxicity

29
Q

Gentamicin IV what is the 1 hour peak + pre-dose trough you want for most ppl

A

1 hour peak 5-10mg/L

Pre-dose trough <2mg/L

30
Q

Gentamicin IV what is the 1 hour peak + pre-dose trough you want for ENDOCARDITIS pts

A

1 hour peak 3-5mg/L

Pre-dose trough <1mg/L

31
Q

Gentamicin IV what to do IF high 1 hour PEAK

A

reduce dose

32
Q

Gentamicin IV what to do if HIGH TROUGH

A

INCR interval bet doses ie stop

33
Q

ACEi monitoring

A

U&Es (creatinine, K+)

-monitor at baseline and after dose changes

34
Q

SE of ACEi

A 
high K+ 
low Na+
AKI - it is CI in RAS BUT it is GOOD IN CKD
cough 
angioedema (months later)
35
Q

CI of ACEi (x1)

A

AORTIC STENOSIS

36
Q

Digoxin Monitoring x2 things

A

U&Es (creatinine, K+)

Levels at least 6 hours post dose (IV)

37
Q

Digoxin excreted from where

A

KIDNEYS

so you need to check for renal dysftn

38
Q

what electrolyte abnormality leads to digoxin toxicity

A

LOW K+

39
Q

Sodium valproate monitoring + WHEN

A

LFTs (ALT, before + during first 6m)

associated with hepatotoxicity so LFTs monitoring at baseline + regular intervals

40
Q

SV SEs

A

Pancreatitis

41
Q

Clozapine what to monitor and who to register with

A

FBC risk of agranulocytosis (BM supression)

+ register with clozapine monitoring clinic

42
Q

Clozapine when to monitor FBC

A

First 18 weeks –> every 1 week
18 weeks - 1 YR –> every 2 weeks
>1YR –> every month

43
Q

when to stop clozapine

A

leucocytes <3000 cells/mm3

neutrophils <1500 cells/mm3

44
Q

what can thiazides cause

A

DYSLIPIDAEMIA , not in eGFR <30

45
Q

what happens if you use furosemide + lithium together

A

INCR lithium concentration (as less renal excretion of lithium)

6th Year PSA (11 decks)

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