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Pharmacology > PSA Monitoring > Flashcards

PSA Monitoring Flashcards

1
Q

Methotrexate Bloods

A 
FBC, LFT, and Renal function
before treatment and 
every 1-2 weeks until a stable dose
Monitoring FBC at regular intervals (2-4 weeks) but once therapy is stabilized 2-3 months
risk of liver cirrhosis
is really excreted
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2
Q

Methotrexate Symptoms

A

Sore throat
fever
bruising

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3
Q

Carbamazepine

A

Plasma concentration at 1-2 weeks
Blood count
hepatic function
renal function tests

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4
Q

Digoxin

A

Plasma concentration at least 6 hours after the dose (not measured unless toxicity, non-compliance, inadequate effect)
Monitor serum electrolytes and renal function

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5
Q

Aminophylline

A

Sample for level

18 hours after starting treatment

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6
Q

Gentamicin monitoring

A

Measure serum concentrations after 3-4 doses
1 hour after IM/IV for peak
just before next dose for trough
every 3 days after a dose change
Monitor renal function before and during
The auditory and vestibular function should be monitored

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7
Q

Gentamicin management

A

If the trough is high, increase the interval between dose

If the peak is high, reduce the dose

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8
Q

Haloperidol

A

Monitor electrolytes

ECG before and during treatment

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9
Q

UF Heparin

A

Platelet counts before treatment and during treatment longer than 4 days
Potassium concentration before and regularly

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10
Q

Phenytoin

A

plasma concentrations

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11
Q

Vancomycin

A

serum measurement on the second day of treatment immediately before the next dose

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12
Q

Warfarin

A

Baseline INR
INR daily/alternate days then at longer intervals of up to 12 weeks
More frequent testing if a change in clinical condition

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13
Q

Warfarin INR 5-9

A

Stop warfarin
Daily INR till normal
Restart when <5

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14
Q

Warfarin INR >9 no bleeding

A

Stop warfarin
give vitamin K 2.5 to 5 mg
INR in 24 hours
Restart when <5

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15
Q

Gentamicin monitoring

A

Peak 1 hr post-dose

Trough just before next dose

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16
Q

Gentamicin peak ranges

A

5-10 mg/L

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17
Q

Gentamicin peak ranges in Bacterial Endocarditis

A

3-5 mg/L

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18
Q

Gentamicin peak out of range

A

adjust dose

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19
Q

Gentamicin tough ranges

A

<2

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20
Q

Gentamicin trough ranges In bacterial endocarditis

A

<1

21
Q

Gentamicin trough ranges out of range

A

adjust dose interval

22
Q

Gentamicin once-daily regimen sampling

A

6-14 hr after the last infusion started

Use nomogram to adjust the frequency

23
Q

Managing Paracetamol OD

A

If staggered OD
time of ingestion unknown
start NAC

Paracetamol levels at least 4 hours after ingestion to use nomogram

24
Q

What to do with warfarin when there is major bleeding

A

Stop warfarin
give 5-10 mg IV vitamin K
Give prothrombinex

25
Q

What to do with warfarin when

INR <6

A

Reduce warfarin dose

26
Q

What to do with warfarin when

INR>5 and there is minor bleeding

A

IV vitamin K 1-3 mg

27
Q

What to do with warfarin when

INR 6-8

A

Omit warfarin for 2 days and then reduce dose

28
Q

What to do with warfarin when

INR >8

A

Omit warfarin and give 1-5 mg oral vitamin K

29
Q

TSH is <0.5

A

Decrease thyroxine dose (smallest increment offered unless grossly hyperthyroid)

30
Q

TSH is 0.5-5

A

Nil action

31
Q

TSH is >5

A

Increase thyroxine dose (smallest increment offered unless grossly hypothyroid)

32
Q

Inadequate clinical response and low serum level

A

Increase dose by smallest possible increment

33
Q

Adequate clinical response but low serum level

A

No change: clinical response is more important

34
Q

Adequate clinical response but high serum levels

A

Decrease the dose EXCEPT gentamicin where the frequency is decreased in the absence of toxicity

35
Q

Evidence of toxicity and high serum levels

A

Omit drug for a few days

36
Q

Lithium monitoring

A

sampled at 12 hours after last dose
normal is 0.4-0.8
toxic effect above 1.5
weekly and then every 3 months
renal function, thyroid, hyperparathyroid, cardiac function and weight every 6 months after starting treatment
sodium depletion increases the risk of lithium toxicity

37
Q

Antipsychotic monitoring

A

fasting blood glucose must be tested at baseline and at regular intervals
baseline ECG in patients with cardiac disease or risk factors

38
Q

COCP monitoring

A

Check BP as hypertension increases the risk of arterial disease associated with CP

39
Q

Amiodarone monitoring

A

pulmonary function tests before starting

liver and thyroid function 6 monthly

40
Q

Sodium valproate monitoring

A

Associated with hepatotoxicity, measure LFT at baseline

41
Q

Clozapine monitoring

A 
Routine FBC is required weekly for 18 weeks then 2 weekly for the remainder of the first year of treatment. If stable then 4 weekly
CVD assessment
signs of hypoglycemia
Signs of myocarditis and heart failures
monitor for constipation
Regular LFTs
42
Q

Tacrolimus levels

A

should be a trough level before morning or evening dose

43
Q

Monitoring resolution of DKA

A

Measure serum ketones after 2 hours of treatment (NOT urinary ketones)
blood pH
pCO2
continue to monitor every 4 hours

44
Q

Vancomycin monitoring

A

pre dose= trough
should be 10-15 mg/L
post-dose levels are not routinely required

45
Q

Response to treatment in polymyalgia rheumatica

A

Symptoms respond rapidly and are the principle guide

46
Q

Vancomycin trough is elevated

A

wait till concentration is within therapeutic range before further dosing
increase dosage interval from 12 hours to 24 hours in patients >85 or with egfr 10-50 mL/min

47
Q

Azothiorpine

A

Cytotoxic
can cause bone marrow suppression and neutropenia, thrombocytopenia FBC must be regularly checked
regular LFT monitoring

48
Q

Theophylline

A

optimal 55-110 micromol/L
measure concentration 4-6 hours after a dose
5 days after oral treatment
3 days after dose adjustment

49
Q

Addison’s

A

Treatment is titrated to symptoms

mineralocorticoids- potassium levels

Pharmacology (17 decks)

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