Drug Monitoring

Question 1

Which are the at risk groups for statin prescribing?

Answer 1

Risk of myopathy
Hx of muscular disorders
Hx of muscular toxicity
High alcohol intake
Renal impairment
Hypothyroidism
Elderly

Question 2

What should be checked when prescribing statins?

Answer 2

ALT and CK

CK if at high risk of myopathy

Question 3

What should you check before prescribing vancomycin?

Answer 3

Serum creatinine

2 main side effects - nephrotoxicity and ototoxicity

Question 4

What should be checked before starting methotrexate?

Answer 4

LFT’s
FBC
U&E
Pregnancy Test

Question 5

What is important to check before starting olanzapine?

Answer 5

Fasting blood glucose

Question 6

What is important to check when continuing a COCP prescription?

Answer 6

Blood pressure

Question 7

What is important to monitor with amiodarone?

Answer 7

LFT’s
Baseline chest xray
T3, TSH and T4

Question 8

What should be monitored during digoxin treatment?

Answer 8

Serum creatinine - U&E

Plasma digoxin concentration if toxicity, non-compliance or inadequate effect

Question 9

What must you check before starting sodium valproate treatment?

Answer 9

ALT

Consider vitamin D supplementation

Question 10

How long must FBC be monitored when starting treatment with clozapine?

Answer 10

Weekly for first 18 weeks

Then fortnightly for upto 1 year
Then monthly