Monitoring Flashcards
What drug monitoring is needed on amiodarone?
Prior to treatment - TFT, LFT, U&E, CXR
TFT, LFT every 6 months
When do you alter the thyroxine dose following TFTs?
TSH level
< 0.5 = decrease dose
0.5-5 = same dose
> 5 = increase dose
When do you monitor gentamicin levels?
6-14h post infusion.
This is then plotted on a normogram.
If too high dose is taken every 36 or 48 hours rather than the regular 24.
When is the peak and trough measured with gentamicin?
Peak 1 hr post dose (too high =adjust dose)
Trough just before next dose (too high = adjust interval)
When is kidney function measured in someone with CKD after starting a ACEi?
1-2weeks following initiation
What is monitored with statins and when?
LFT
Baseline, 3 month and 12 m.
What is monitored in sodium valproate?
LFT
LFT and FBC baseline, then LFT periodically in first 6ms
What is monitored in Lithium?
Lithium level - weekly until stable then every 3 months
TFT and u and e at baseline and every 6 m
How do you monitor effectiveness of furosemide treatment?
Weight reduction
How to monitor beneficial effects of heart failure treatment?
Improved exercise tolerance
What needs to be monitored in cyclosporine treatment,?
First 2 weeks - Nephrotoxicity - monitor renal function eg creatinine
Later - liver function too - monthly
What should be checked prior to starting someone on simvastatin?
Liver function tests (AST and ALT), contraindicated in poor hepatic function as its metabolised by the liver and could increase levels leading to myopathy.
When is the lithium level checked after the dose?
12hours
Which electrolyte abnormality increases the risk of lithium toxicity?
Sodium depletion
When to check FBC in methotrexate treatment?
Every 2-3 months
How is methotrexate excreted?
Renally (more toxicity in renal failure)
What needs to be checked prior to starting olanzipine?
Fasting blood glucose.
ECG - if have cardiovascular disease
What should be checked prior to amiodarone treatment?
Chest X-ray (due to pulmonary toxicity)
LFT ( at regular intervals)
Cautioned in patients with hypokalaemia
What should be monitored during treatment in digoxin?
Renal functions (creatinine)
And k+, as hypokalemia increases risk of digoxin toxicty.
What needs to be checked prior to starting sodium valproate treatment?
Liver function tests (ALT) as can cause hepatotoxicity
How is clozapine monitored?
FBC every week, for first 18 weeks of treatment. And must register with a clozapine monitoring service. Stop the drug if any signs of neutropenia.
What monitoring is required in IV phenytoin administration?
ECG as cardiac arrhythmias
What’s the treatment for low warfarin INR levels?
Increase the dose (and cover for the time it will take to work with a quick acting anticoagulant eg LMWH.)
