Monitoring requirements - Cardiac Drugs & Anti-coags

Question 1

When someone is prescribed ACE inhibitors, what should be assessed and monitored?

Answer 1

Renal Function

Electrolytes

Question 2

How often should a person taking ACE inhibitors have their renal function and electrolytes checked?

Answer 2

Before starting

Regularly during treatment

Question 3

What are the monitoring requirements for Beta Blockers

- selective and non-selective?

Answer 3

Lung function in those with history of obstructive airway disease

Question 4

What are the monitoring requirements for those taking thiazide diuretics?

Answer 4

Electrolytes should be monitored particularly for high dose and long term use

Question 5

What should be monitored for patients taking warfarin?

Answer 5

Base-line prothrombin
INR daily or on alternate days in early days of treatment, then at longer intervals (depending on response), then up to every 12 weeks.
Change in patient’s clinical condition, particularly associated with liver disease, intercurrent illness, or drug administration, necessitates more frequent testing.

Question 6

Patient/carer advice for ACE inhibitors?

Answer 6

None

Question 7

Patient/carer advice for Beta blockers?

Answer 7

Can mask symptoms of hypoglycaemia

Question 8

Patient/carer advice for Thiazides?

Answer 8

Consider onset of action time

Question 9

Patient/carer advice for warfarin?

Answer 9

Anti-coag booklet (inc advice and alert card, section recording INR)
Stop taking 72 hours before surgery
Pomegranate increases INR in response to warfarin