Drug monitoring

Question 1

lithium

Answer 1

renal function

risk of nephrotic syndrome and nephrogenic diabetes insipidus

Question 2

simvastatin

Answer 2

LFTs - before, 3m and 12m

ALT >x3 upper limit - stop therapy

Question 3

HbA1c target on a hypoglycaemic or 2 drugs

Answer 3

53

Question 4

HbA1c target for diet controlled or just metformin

Answer 4

48

Question 5

when to add a second drug t2DM

Answer 5

HbA1c 58

Question 6

max dose of paracetamol

Answer 6

4g/day

watch out for co-codamol

Question 7

how to know of someone on oxygen is hypoxic

Answer 7

• 10 from Fio2, the pao2 should be higher than that number

Question 8

narrow therapeutic index

Answer 8

digoxin
lithium
phenytoin
theophylline
gent
vanc

Question 9

digoxin toxiciy

Answer 9

confusion
nausea
halos
arrhythmia

slow AF - stop dig

Question 10

lithium

Answer 10

tremor, diarrhoea, tired
arrhythmia, seizure, coma
renal failure, diabetes insipidus

Question 11

phenytoin

Answer 11

gum hypertrophy
ataxia
nystagmua
peripheral neuropathy

teratogenic

Question 12

gent/vanc

Answer 12

oto/nephrotoxic

Question 13

tapering steroids

Answer 13

40mg for 1 week
3 weeks
recent courses repeatedly

Question 14

things that potentiate warfarin - increase INR

Answer 14

enzyme inhibitors - AO DEVICES
liver disease
cranberry juice
NSAIDs - displace warfarin from albumin and lower platelets
amiodarone
metronidazole
SSRIs

Question 15

adjust dose of <50kg

Answer 15

enoxaparin

paracetamol