Drug monitoring Flashcards
when do you measure the levels of ciclosporin
trough levels immediately before dose
what and when is needed for monitoring of statins
LFTs at baseline, 3 months and 12 months
what is the range for lithium
0.4-1
when to measure lithium levels
12 hours post dose
when to measure levels digoxin
at least 6 hours post dose
when to measure phenytoin levels
trough levels, if adjusting dose or suspected toxicity
monitoring ACEi
U&E prior to treatment, after adjusting dose, at least annually
monitoring amiodarone
TFT, LFT, U&E, CXR prior to treatment. TFT and LFT every 6 months
monitoring methotrexate
FBC, U&E, LFT before treatment and repeated weekly until therapy stabilised, then every 2-3 months
monitoring azathioprine
FBC, LFT before treatment, FBC weekly for first month, FBC LFT every 3 months
monitoring lithium
TFT, U&E before treatment, lithium levels weekly until stabilised then every 3 months
monitoring sodium valproate
LFT, FBC every 6 months. LFT periodically for 6 months
monitoring glitazones
LFT before treatment and during treatment
what should be measured in patient taking vancomycin
creatinine to check for renal dysfunction
when are statins contraindicated
if AST/ALT over 3x normal range
how is methotrexate excreted
mainly renally so toxicity more likely in renal dysfunction
monitoring with olanzapine
fasting blood sugars measured at baseline and regular intervals due to risk of hyperglycaemia and diabetes. FBC every year
monitoring clozapine
FBC checked weekly for first 18 weeks. registration with clozapine monitoring service for all patients
what needs to be monitored when starting phenytoin infusion
cardiac monitoring due to its pro arrthymogenic effects
when should you check theophylline levels
18hours after starting Rx or of concerns of toxicity
when does the dose/ dose interval need to be changed when the patient is on gentamicin
if the peak is too high- reduce dose. if the trough is too high- lengthen dose interval
what should be monitored when starting an aminosalicylate eg mesalazine
U&Es before starting, 3months and every year
