Drug monitoring

Question 1

Patient with heart failure given perindopril - what is the most appropriate way to measure its beneficial effects in the first month?

Answer 1

Exercise tolerance

Question 2

How to monitor adverse effects of ciclosporin?

Answer 2

Serum creatinine

Big SE are nephrotoxicity and hypertension

Question 3

What is the most appropriate way to measure the beneficial effects of allopurinol?

Answer 3

Serum urate (via inhibiting activity of xanthine oxidase)

Question 4

What is the effect of lithium that should be monitored?

Answer 4

Affects the kidney - leads to nephrotic syndrome and diabetes inspidus

Hence monitor renal function

Question 5

Best way to assess the adverse effects of HRT?

Answer 5

Blood pressure - stop if BP rises above 160mmHg (causes sodium and fluid retention)

Question 6

Phenytoin infusion - what is the most important thing to monitor?

Answer 6

ECG - IV admin is associated with cradiac arrhythmias

measure phenytoin plasma levels would be more appropriate a couple of hours AFTER the infusion

Question 7

Patient prescribed Tazocin for community acquired pneumonia - what would most adequately assess the response to abx whilst an inpatient?

Answer 7

SpO2 or ABG; or RR

Consolidation in a CXR would take up to 6w to clear