Drug monitoring

Question 1

Statins

Answer 1

LFTs at baseline, 3 months and 12 months

Question 2

ACE inhibitors

Answer 2

U&E prior to treatment, after increasing dose and at least annually

Question 3

Amiodarone

Answer 3

TFT, LFT, U&E (specifically looking at potassium), CXR prior to treatment
TFT, LFT every 6 months

Question 4

Methotrexate

Answer 4

FBC, U&E and LFTs before starting treatment, repeated weekly until therapy stabilised and should be monitored every 2-3 months from then on

Question 5

Azathioprine

Answer 5

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

Question 6

Lithium

Answer 6

TFT, U&E prior to treatment
Lithium levels (taken 12 hours after last dose) weekly until stabilised then every 3 months
TFT, U&E every 6 months

Question 7

Sodium valproate

Answer 7

LFT before treatment and ‘periodically’ during first 6 months

Question 8

Glitazones

Answer 8

LFT before treatment and ‘regularly’ during treatment

Question 9

Phenytoin

Answer 9

Phenytoin levels do not need to be monitored routinely but trough levels should be checked immediately before dose if - adjustment of phenytoin dose, suspected toxicity, detection of non-adherence to the prescribed medication