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PSA AM > Drug monitoring > Flashcards

Drug monitoring Flashcards

1
Q

What antibiotics require monitoring?

A

Vanc

Gent

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2
Q

What are some common drugs that require monitoring?

A 
Warfarin 
Digoxin 
Lithium 
Valproate 
Clozapine
Amiodarone
Thyroxine, carbimazole
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3
Q

When should Vanc be avoided?

A

Severe renal impairment

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4
Q

What is the dose of vanc?

A

15-20mg/kg

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5
Q

What are the goal trough levels of vanc?

A

10-15mg/L

15-20mg/L in severe infection

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6
Q

When should gent be avoided?

A

Renal impairment

Pregnancy and breastfeeding

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7
Q

What is the dose of gent?

A

5mg/kg

Half in renal failure

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8
Q

When should gent be monitored?

A

After 3 doses, then every 3 days

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9
Q

When and what are peak levels of gent?

A

1 hour post dose

5-10mg/L

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10
Q

When and what are trough levels of gent?

A

<2mg/L

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11
Q

What should you do if gent levels are high?

A

High peak= decrease dose

High trough= increase time between doses

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12
Q

What is the initial monitoring of warfarin?

A

Daily or every other day until stable

Then increasing intervals

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13
Q

What is the max amount of time between warfarin INR checks?

A

12 weeks

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14
Q

What is the management of a major bleed on warfarin?

A

Stop warfarin
vit K
Prothrombin

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15
Q

What is the management of an INR >8?

A

Stop warfarin

Vit K

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16
Q

What is the management of INR 5-8?

A

Minor bleeding= stop warfarin, vit K

No bleed= withhold until INR <5

17
Q

What is monitored with lithium?

A

Lithium levels

U&Es, TFTs

18
Q

How often are lithium levels monitored?

A

Weekly until stabilised then 3 monthly

19
Q

When are U&Es and TFTs monitored with lithium?

A

6 monthly

20
Q

What monitoring is required with clozapine?

A

FBC

21
Q

How often is FBC monitoring with clozapine?

A

<6mo= weekly
6mo-1year= fortnightly
>1 year= monthly

22
Q

What is monitored with valproate and when?

A

LFTs, FBC

6 months then annual

23
Q

What is the monitoring in thyroxine and carbimazole?

A

6-8 weeks, 4-6 months then annual

24
Q

What is monitored with amiodarone?

A

TFTs, LFTs 6 monthly
CXR and K before commencing
ECG

PSA AM (7 decks)

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