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BNF crash course > High risk drugs > Flashcards

High risk drugs Flashcards

1
Q

what are the monitoring requirements for vancomycin?

A 
FBC
Serum potassium
Auditory function 
Renal function
Urinalysis
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2
Q

What is the Target serum concentration for vancomycin?

A

10 - 15 mg/L for normal infection

15-20 mg/L for more serious infections

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3
Q

What are the warning sings of vancomycin?

A 
Ototoxicity
Nephrotoxicity 
Hypokalaemia 
Thrombophlebitis 
Red man syndrome 
Blood disorders such as thrombocytopenia or neutropenia
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4
Q

What are common interactions of vancomycin?

A

Increased risk of nephrotoxicity and ototoxicity if given with gentamicin, loop diuretics or ciclosporins

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5
Q

What bacteria is vancomycin commonly used against?

A

Gram positive aerobic and anaerobic bacteria including MRSA

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6
Q

What bacteria is gentamicin commonly used against?

A

Pseudomonas aeruginosa

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7
Q

What are the serum gentamicin concentration targets for single dose and multiple dose treatments?

A

Single dose:

  • Peak is 5 -10mg/L
  • Trough is <2mg/L

Multiple dose:

  • Peak is 3-5mg/L
  • Trough is <1mg/L
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8
Q

What are the common warning signs of gentamicin?

A 
Nephrotoxicity 
Ototoxicity 
Thrombophlebitis 
Nausea and Vomiting 
C. Diff 
Blood disorders
Seizures
Peripheral neuropathy
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9
Q

What are the common interactions of gentamicin?

A

Increased risk of ototoxicity with loops and vancomycin

Increased risk of nephrotoxicity with ciclosporin, platinum chemotherapy, cephalosporins or vancomycin

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10
Q

In which patients should amiodarone be avoided?

A

Heart block
Hypotension
Active thyroid disease

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11
Q

What are the monitoring requirements of amiodarone?

A

LFT before starting treatment and every six month
Thyroid levels before starting treatment and every six month
Renal function
Chest X-ray
Serum K/Mg levels- can result in hyper
Eye test once a year

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12
Q

What are the warning signs of amiodarone?

A 
Hypo/Hyper thyrodism 
Skin toxicity i.e. burns or grey skin discolouration 
Phototoxicity 
SOB 
Liver disease 
Neuropathy 
Bradycardia
Taste disturbances
N/V
Sleep disorders
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13
Q

What are the usual therapeutic doses of digoxin?

A 
AF= 125-250mcg OD
HF= 62.5-125mcg OD
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14
Q

What are the target serum concentration of digoxin?

A

1 to 2 mcg

Dose measured after 6hrs of administration

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15
Q

What are the monitoring requirements of digoxin?

A 
Electrolytes (hypo Mg/K/Ca can increase the risk of digoxin toxicity)
Liver function 
Kidney function 
Heart rate (can't fall below 60 Bpm)
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16
Q

What are the warning sings of digoxin?

A 
GI disturbances i.e. NV
Visual disturbances i.e. yellow vision
Bradycardia 
Rash 
Dizziness
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17
Q

What conditions are CI with digoxin?

A

Second-degree Heart block
Intermittent complete heart block
Ventricular arrhythmias

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18
Q

What drugs interact with digoxin can result in increased risk of hypokalaemia ?

A

Loops and thiazide diuretics

19
Q

What drugs interact with digoxin can result in increased digoxin toxicity?

A

Amiodarone
CCB
Spironolactone
Quinine

20
Q

What is phenytoin serum concentration target?

A

10-20mg/L

21
Q

What are the monitoring requirements of phenytoin?

A

Liver function because phenytoin is highly protein bound
Vitamin D- phenytoin increases metabolism of vitamin D
FBC
Serum concentration
Phenytoin is an antifolate so folate concetration

22
Q

What are the toxicity signs of phenytoin?

A 
CV collapse
Respiratory depression
Suicidal thoughts
Skin disorders
Blood disorders
Nystagmus 
Ataxia 
Low vitamin D- can result in osteomalacia "softening of the bones"
Slurred speech
Diplopia
Slurred speech
23
Q

What is carbamazepine serum concentration target?

A

4-12mg/L measured before administration of next dose

24
Q

What are the warning sings of carbamazepine toxicity?

A 
IHANDBAG
Incoordination 
hyponatraemia 
Ataxia 
Nystagmus 
Drowsiness
Blurred vision 
Arrhythmia 
GI disturbances

+ Oedema

25
Q

What are the serum lithium concentration targets?

A
  1. 4 to 1 mg/l
  2. 4mg/l for elderly
  3. 5+ is toxic
26
Q

What are the warning sings of lithium toxicity?

A 
Apathy
Restlessness
Vomiting 
Diarrhoea 
Ataxia 
Hypernatremia 
Visual disturbances 
Cardiac arrhythmia 
Seizures
27
Q

What are the monitoring requirements for lithium?

A 
FBC
Cardiac 
Renal
Thyroid 
BMI 
Serum electrolyte i.e. sodium
28
Q

What is the warfarin target for new onset VTE, AF, post MI?

A

2.5

29
Q

What is the warfarin target for recurrent VTE or mechanical prosthetic heart valves?

A

3.5

30
Q

What are the colours of the warfarin tablets?

A 
0.5mg = white
1mg= brown
3mg= blue
5mg= pink
31
Q

How long is the duration of treatment with warfarin for isolated calf DVT?

A

6 weeks

32
Q

How long is the duration of treatment with warfarin for provoked DVT?

A

3 months

33
Q

How long is the duration of treatment with warfarin for unprovoked DVT?

A

3months +

34
Q

What are the warning signs of warfarin?

A 
Signs of excessive bleeding 
Purple toes
Rash/ Skin necrosis 
Diarrhoea/Vomiting 
Headaches/ Confusion 
Signs of thrombosis
35
Q

What are the monitoring requirements of warfarin?

A 
Clotting screen
Liver function
Renal function
FBC
BP
Thyroid function
36
Q

What is the plasma theophylline concentration target?

A

10-20mgL

Measured after starting or dose adjustment

37
Q

What causes an increase in plasma theophylline concentration?

A

Heart failure
Hepatic impairment
Viral infections

38
Q

What causes a decrease in plasma theophylline concentration?

A

Smoking

Alcohol

39
Q

What are the warning signs of theophylline toxicity?

A 
Hypokalaemia 
Hyperglycaemia 
Convulsion
Hematemesis - throwing up blood
Cardiac arrythmias
Dilated pupils 
Restlessness
Agitation
Vomiting
40
Q

What are the monitoring requirements of ciclosporins?

A 
FBC
Liver function
Serum electrolytes
Blood lipids
Renal function
Dermatological/ Physical examination
41
Q

What are the warning signs of ciclosporins?

A 
Liver toxicity 
Nephrotoxicity 
Neurotoxicity 
blood disorders
hypertension
Headache 
Gingival hyperplasia - overgrowth of gum 
Hyperkalaemia
42
Q

What are the monitoring requirements for tacrolimus?

A 
Blood glucose levels
Liver function
Kidney function
Eyes
Blood pressure
ECG
43
Q

What are the warning signs for tacrolimus toxicity?

A 
Hyperglycaemia 
Hyperkalaemia 
Hyponatraemia 
Photophobia 
Liver toxicity 
Blood disorders 
CV disorders

BNF crash course (6 decks)

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