Drug monitoring Flashcards
What should you monitor for these drugs
- statins
- vanc & gent
- cOCP & HRT
- amiodarone
- ACEi
- digoxin
- valpotare
- cloazapine
- DKA treatments
- SSRIs
- pneumonia treatment
- O2 therapy & aminophyline
- allopurionl
- IV fluids
- lithium
- ALP or CK
- renal function (creatinine)
- BP
- baseline CXR
- U&Es
- renal function (creatinine)
- LFTs (e.g. ALT)
- FBC
- ketones
- suicidal thougths
- RR
- o2 sats
- urate
- BP
- renal function
what should you usually monitor for a drugs ‘therapeutic effect’
Like vital signs & shit
Not gonna be a drug’s concentration
what to you monitor in statins
Sore muscles -> CK
no sore muscles -> ALP
Does digoxin fuck your kidneys or liver
kidneys
what investigation do you need to do before starting amiodarone
CXR
for monitoring SSRIs, what should you check after 2 weeks and 4 weeks
2 weeks -> rash
4 weeks -> suicial thoughts
obvs it takes like 4-6 weeks to kick into action
if the level of a drug is below what it shoudl be, but the pt is seeing benefits from it, what should you do?
Nothign mate
therapeutic index is most important
if it works for them, then happy days eh cheeeeers
when should you monitor gent
8hrs post-dose
if you’re unsure what to monitor, what should you check for
Common/seriour SEs eh
Gent levels
What should these be & what shoudl you do if not right
Peak level
Trough level
Peak level
Normal -> 5-10
IE -> 3-5
Change the dose if abnormal
Trough level
Normal -> <2
Chaneg dose interval if abnormal
for the benefical effecets of anti-hypertensives, what should you monitor
HR
what is the normal range of lithium
0.4 -> 1
when should you do blood test for a paracetamol OD
4hrs after taking it
Warfarin shite & INR
What shoudl you do if a pt on warfrain has the following INR results…
- 5-6
- 6-8
- >8
- Decrease dose
- stop for 2 days, start again at lower dose
- stop & give Vit K
Signs of toxicity -> probs should monitor eh
- lithium
- digoxin
- phenytoin
- Gent & vanc
- tremors -> tierdness -> arrythmias, coma, seizure
- bradycardia, ‘halos’ in vision, confusion, arrythmia
- sore gums, ataxia, peripehral nueropathy
- hearing loss & AKI
What are the early, mid, and late signs of lithium toxicity?
Early -> tremor & diarrhoea
Mid -> tierdness
late -> confusion, coma & arrythmias
If the levels of a drug are in the normal range, can it be an OD
Obvs fucking not
Pt can be allergic to it tho lol
what drugs increase the risk of lithium toxicity?
ACEi & diuretics
reduce lithoum excretion eh
lets say a pt is being given too much paracetamol as a result of being prescribed both paracetamol and co-codamol
if they are still in pain, which one should you stop?
paracetamol
probs need the extra strength of the co-codamol
what bit in the BNF can tell you about tests to fo before starting treatment
pre-treatment screening
what needs to be monitored after a blood transfusion
Heart rate, blood pressure and temperature
how do you monitor the beneficila effects of B-blockers & digoxin
Fucking hell, for all anti-hypertensives and anti-arrythmics
HR
for anti-psychotics, what do you need to monitor after a week
Weight
BMI
what do you monitor for insluin-glucose infusions
BG
who would’ve fucking thought eh
for thryoid drugs like carbimazole, what do you monitor after 6 weeks
TFTs ehhhhhh
whats good to monitor after like 4 days of ABXs
CRP
See if the infection has gone down eh
what do you monitor 30mins after starting oxygen therapy
ABGs
what do you monitor after getting fluids
HR & BP
whats best way to monitor the therapeutic benefit of diuretics
WEIGHT
if TSH are stable, when should you do TFTs?
Once a year mate
how do you monitor for advsere effects of heparin
FBC
if you get LFTs and there’s statins involved, what would you do to the dose
Probs just fucking leave it yeah
what test to you do to check that you’re getting the right dose of warfarin
INR
what tests to you do to monitor contraceptives
Weight & BP
what do you monitor for the benedicial effects of diuretcis
weight
