Major Drug Side-effects & Monitoring Flashcards
Major side effects of TB Treatment
Rifampicin – Hepatitis, rashes, febrile reaction, orange/red secretions (N.B. contact lenses),
many drug interactions including warfarin and
OCP
Isoniazid – Hepatitis, rashes, peripheral
neuropathy, psychosis
Pyrazinamide – Hepatitis, rashes, vomiting,
arthralgia
Ethambutol – Retrobulbar neuritis
Therefore, MUST do a baseline visual acuity test and LFT’s which must be monitored
closely
Enzyme inhibitors
SICKFACES.COM Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Alcohol..binge drinking Chloramphenicol Erythromycin Sulfonamides Ciprofloxacin Omeprazole Metronidazole
Enzyme inducers
Barbituates St. John’s wort Carbamazepine Rifampin Alcohol (chronic) Phenytoin Griseofulvin Phenobarbital Sulfonylureas
Amiodorone
Pulmonary fibrosis, liver and thyroid dysfunction, optic neuritis
Azathioprine
More side effects if TPMT enzyme deficient
Can cause very severe bone marrow suppression if allele is deficient or absent
Drug interaction with allopurinol
Oftenusedasasteroidsparingagent
Anti-TNF therapy
Needs DAS assessment (according to NICE)
All brands are parenteral
Increased risk of infection with intracellular pathogens
Reactivation of TB
Drug contraindicated in psoriasis due to a recognised association with erythroderma
Chloroquine
Chloroquine ADRs
Retinopathy and corneal opacities, deafness, photosensitivity, hair discolouration and alopecia
Drug monitoring - Statins
LFTs at baseline, 3 months and 12 months
ACE inhibitors drug monitoring
U&E prior to treatment
U&E after increasing dose
U&E at least annually
Amiodorone drug monitoring
TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
Methotrexate drug monitoring
FBC, LFT, U&E
Every week until stable and then every 2-3months
Azathioprine drug monitoring
FBC, LFT before treatment
FBC weekly for the first 4 weeks
FBC, LFT every 3 months
Lithium drug monitoring
TFT, U&E prior to treatment then every 6 months
Lithium levels weekly until stabilised then every 3 months
Sodium valproate monitoring
Sodium valproate LFT LFT, FBC before treatment
LFT ‘periodically’ during first 6 months