Monitering Flashcards
Monitering req Statins
LFTs
Monitering req Ace inhibitors
U&E
Monitering req Amiodarone
LFTs &TFTs
Monitering req Methotrexate
FBC, LFT, U&E
Monitering req Azathioprine
FBC LFT
Monitering req Lithium
lithium level
TFT
U&E
Before starting - FBC TFT U&E and BMI (ECG if cvd disease) then every 6 months
Check lithium level 12 hrs (0.4-1mmol/l) after starting and weekly after starting/changed dose until stable
Then 3monthly for first year then 6monthly after that
Monitering reqSodium Valp
LFT
Monitering req Glitazones
LFTs
Changing levothyroxine dose use what and how
Use TSH
<0.5 decrease dose
0.5-5 carry on
>5 increase dose
LFT pattern in Prehepatic disease
Causes
Bilirubin up
haemolysis
Gilberts
LFT pattern in intrahepatic disease
causes
Bilirubin up
AST & ALT up
Fatty liver
Hepatitis
Cirrhosis
primary n secondary malig
Wilsons/haemochromatosis
Heart failure (hepatic congestion)
causes of hepatitis and cirhosis
Alcohol
Viruses (hep A-E, CMV,EBV)
Drugs (Paracet OD, Statins, rifampicin)
Autoimmune
LFT pattern in posthepatic (obstructive) disease
Causes
Bilirubin up
ALP up
Lumen:
gallstone, cholestasis causing drugs
Wall:
Cholangiocarcinoma
Primary biliary cirrhosis
sclerosing cholangitis
Extrinsic pressure:
Panc/gastric Ca
Lymph node
drugs that cause cholestasis
(= risking posthepatic LFT derangement)
Flucloxacillin
Co-amox
nitrofurantoin
steroids
sulphonureas
Ciclosporin monitoring b4 and during
Baseline renal fxn & every two weeks until stable results
Regular BP
Statins monitoring n why
what to do if deranged
Myopathy
Cr > 5x upper limit of normal
Stop statin, if sx resolve & Cr normal = reintroduce statin at a lower dose
what to do with amiodarone caused hypothyroid
continue amiodarone and start levothyroxine
ACEi when starting tx
and what to do
<20% increase in Cr expected
dont change dose - repeat U&Es after a week
what to monitor if on UFH
aPTT
and plts
What to monitor if on LMWH
Anti factor Xa
measuring beneficial effects of ACEi
exercise tolerance
monitor on sodium calp
LFTs
