Psych-Neuro-Msk Flashcards

1
Q

Acute Agitation

in Delirium DOC

A

Antipsychotic Risperidone or Haloperidol

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2
Q

Acute Agitation

in Dementia DOC

A

Very low dose of Risperidone

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3
Q

Acute Agitation

in Brain Injury DOC

A

Propranolol

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4
Q

Acute Agitation

in DLB DOC

A

Memantine or Anticholinestrase

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5
Q

Acute Agitation

in Psychosis DOC

A

Antipsychotic +|- Lorazepam

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6
Q

Acute Agitation

in Mania DOC

A

Antipsychotic +|- Lorazepam +|- Mood stabilizer

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7
Q

IM Olanzapine Caution

A

Do not use it with parenteral BZPs

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8
Q

Acute Agitation

if Situational Or if caused by drug abuse DOC

A

Both:

Haloperidol 5 mg Oral or IM

+ Lorazepam 2 mg Oral or IM

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9
Q

ADHD Treatment

in below 6 yo

A

Only nonpharma,

no Medications +Behavioral therapy

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10
Q

ADHD

1st line tx: Stimulants Or……..

A

Atomoxetine (NE Reuptake inhibitor)

(If no response or intolerance to stimulants)

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11
Q

ADHD

Two medications with no potential for abuse

A

Atomoxetine

Guanfacin (Alpha 2 Agonist)

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12
Q

ADHD

How to prescribe Methylphenidate SR?

A

Trial for 3-4 w

Then continue for 6-12 months

Then 1-2 months holiday and reassess

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13
Q

ADHD

Wen do you prescribe Alpha 2 agonists?

Guanfacin, Clonidin

A

Both: More effective on hyperactivity and impulsivity

G: less SEs

C: if Tic disorder coexists

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14
Q

Panic disorder DOC

A

SSRI or SNRI

+|- Clonazepam (maximum 6-8 w)

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15
Q

Agoraphobia DOC

A

SSRI or SNRI

+|- CBT

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16
Q

Social Anxiety Disorder

1st line: SSRI or SNRI

2nd line: ………..

A

Moclobemide (MAOI-A, reversible)

Caution: Avoid with SSRI or TCA or Meperidine

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17
Q

Specific Phobia DOC

A

No medication:

Only CBT

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18
Q

GAD 1st line: SSRI or SNRI

If no response or intolerant, then ……….

A

Pregabalin

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19
Q

Anxiety or Mood Disorders

Best SSRIs if Breastfeeding (2)

A

Paroxetine

Sertraline

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20
Q

Smoking Cessation 5”A”s

A

Ask

Advise

Assess

Assist

Arrange

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21
Q

Smoking Cessation: Nonpharma

  1. Pick a Date
  2. Asking for Help
  3. Social support

4,5,6 ?

A

Medications

Counselling

+|- CBT 8-24 W

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22
Q

Smoking Cessation: In Pregnancy

A

Preferably no medications

If not, either Gums or Bupropion

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23
Q

BMD

Acute Episode of Mania DOC

A

Risperidone +|- Li

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24
Q

BMD Episodes of Depression:

1st line

…………. or ……………. or …………..

A

Li or Lamotrigine or Li + Bupropion

(avoid monotherapy with antidepressants)

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25
BMD Li Monitoring: 1. Thyroid 2. Renal function 3,4 ?
Electrolytes 24h urine and Clearance of Cr
26
BMD Li Overdose signs/symptoms (5) 1,2 Ataxia Tremor 3,4 Diarrhea Vomiting 5,6 ?
Sedation/Agitation Seizures
27
BMD Valproate SEs (5) 1. Teratogenic 2. Wt gain 3. Hepatotoxic 4,5 ?
Thrombocytopenia PCOS
28
BMD Li SEs (6) 1,2 DI, Hypothyroidism 3,4 Tremor, GI 5,6 ?
Wt gain Impotence
29
BMD Li drug interactions
Caution with: Thiazides (Important), NSAIDs, ACEIs, ARBs,
30
BMD If cognitive impairment with Li
Decrease dosage Or use SR form of Li
31
OCD 1st line tx
1st. SSRI + CBT 2nd. SNRI + CBT
32
Anorexia Nervosa 1st line tx
Prokinetics: Domperidone (best) Metoclopramide Erythromycin Prucalopride (new)
33
Anorexia Nervosa Adjunctive treatments 1. Zinc Gluconate 2. Olanzapine 3,4 ?
Thiamine Cyproheptadine
34
Bulimia Nervosa: DOC
SSRI + CBT (Usually: Fluoxetine)
35
PTSD Tx within first month after trauma
Avoid BZPs Avoid Antidepressants + Trauma-focused psychotherapy
36
PTSD 1st line tx
SSRI or Venlafaxine +|- augmentation with Risperidone
37
PTSD Why should we avoid monotherapy with BZPs?
Abuse, Disinhibition
38
PTSD If associated with insomnia DOC
Trazodone Or Perazosin
39
Insomnia 1st line
Temazepam 15 mg QHS or Oxazepam 10-15 mg QHS
40
Insomnia Best Agonist of BZPs
Zopiclone 3.75 mg QHS
41
Insomnia In Pregnancy
BZP ~ ok Zopiclone ~ ok Zolpidem: No
42
Dementia Alzheimer's: 1st line
Anti cholinestrase Inhibitors Donepezil Or Rivastigmine Or Galantamine
43
Dementia Alzheimer's: 2nd line
NMDA Antagonists Memantine (Ebixa)
44
Dementia Alzheimer's: Anticholonestrase inhibitors SEs 1,2 GI intolerance, PUD or GI Bleeding 3,4 ?
Seizures Worsening of Asthma or COPD
45
Dementia Alzheimer's: Most commonly prescribed drug is.......
Donepezil (In all stages of Alzheimer's)
46
Dementia DOC in Lewy Body Dementia
Rivastigmine
47
Dementia Caution in DLB
Never prescribe antipsychotics because of AP Sensitivity Sd: Irreversible Parkinsonism or Autonomic Disorders or Confusion
48
RBD in Dementia (Responsive Behaviors in Dementia) If antidepressant: SSRI If antipsychotic: very low dose If movement disorders: .......
Quetiapine (Does not cause EPS or movement Disorders)
49
RBD in Dementia (Responsive Behaviors in Dementia) If Agitated Or Sundowning Or Insomniac
Best: Trazodone
50
Depression Three antidepressants with lowest Sx SEs 1. Bupropion 2........ 3........
Mirtazapine Moclobemide
51
Depression Antidepressants discontinuation Sd is more common with Short half lives like .........
Venlafaxine Paroxetine
52
Depression To avoid Antidepressants discontinuation Sd :
Decrease 25% dosage per week
53
Depression Moclobemide is a 1st line tx Serotonin Sd? HTN Crisis?
S: yes, with SSRIs or TCAs or Meperidine H: No
54
Depression Three indications for referral 1. Suicidal 2. ........ 3.........
Psychotic Features 3 times failure
55
Depression Antidepressants in Pregnancy
SSRI is ok But preferably not in 3rd trimester
56
Depression Examples of Augmentation tx Li, T3, Atypical AP, Modafinil, Ritaline, ..........
SSRI + Bupropion
57
Depression Switching from MAOI to another antidepressant
2 weeks wash out
58
Depression Switching from an antidepressant (other than Fluoxetine) to MAOI
5 half lives wash out
59
Depression Switching from Fluoxetine to MAOI
5 weeks wash out (=5 half lives)
60
Depression Switching from Moclobemide to another antidepressant
5 days wash out (=5 half lives)
61
Stimulants Withdrawal Tx?
SR forms of Amphetamines or Ritaline
62
Opioids Withdrawal Tx Three medications: Methadon ........... ...........
Buprenorphine Buprenorphine + Naloxone
63
BZPs Withdrawal Tx?
Long Acting BZP like Diazepam And taper slowly If insomnia: Trazodon
64
NAS Neonatal Abstinence Sd (Opioids) Tx: 1. Nonpharma (7) ? 2. Diluted tincture of Opium
Swaddling, Gentle Rocking Holding, Pacifier Low volume high calorie meals, Repetitive diaper change, Silence + white noise and +/- Methadon to the Breastfeeding mother
65
Psychoses Three APs that should be taken in the mornings? Aripiprazole, ........, .........
Paliperidone Ziprasidone
66
Psychoses Two APs that should be taken with food
Lurasidone Ziprasidone
67
Psychoses Caution with Asenapine (2)
Oral hyposthesia Probable hypersensitivity or Angioedema
68
Psychotic Agitation Haloperidol 5 mg +/- Lorazepam 2 mg Or ........
Oral rapid dissolving form of Olanzapine or Risperidone (If the patient cooperates)
69
Psychoses Two APs in which the dosage should be increased rapidly to avoid activation Sd
Ziprasidone XR form of Quetiapine
70
Psychoses DOC for smoking Cessation?
NRT is preferred
71
Psychoses NMS (medical emergency) DOC?
Dantrolene IV + hydration and cooling +|- Bromocriptine Oral
72
Psychoses Three SGA APs with highest sedation Quetiapine, ......., .......
Olanzapine Clozapine
73
Psychoses Two SGAs with highest risk of EPS
Risperidone Paliperidone
74
Psychoses Tx of Akathisia: 1. Decrease dosage 2. .......
Propranolol or BZP
75
Psychoses AP with highest CVS SEs
Clozapine
76
Psychoses In Pregnancy: 1. Minimum effective dose is recommended 2 ?
No AP is preferred to others
77
Psychoses DOC Acute Dystonia
IM Benztropine Or IM Diphenhydramine
78
Acute Pain Meperidine (Pethidine) CIs: Hepatic disease, Renal disease, Elderly, ......., .......
MAOIs within last 2 weeks Pain longer than 3 hours
79
Acute Pain Three examples of local anesthetics 1. Lidocaine (+/- Epinephrine) 2,3 ?
TAC (Tetracaine, Adrenaline, Cocaine) EMLA (Mixture)
80
Acute Pain Opioids in Pregnancy?
Are safe (if low dose and caution close to term)
81
Acute Pain Opioids in Breastfeeding
Generally Safe (except for Meperidine, Codein)
82
Bell's Palsy DOC? (Tx should be started within first 72 hours)
Prednisone Oral 5 days (1 mg/kg) +|- Acyclovir (Then taper in 5 days) But If paralysis is complete: CS for 10 days (Then taper in 5 days)
83
Chronic Fatigue Sd Nonpharma: ............, good nutrition, good sleep, multivitamins, enough salt, CBT
GET Graded Exercise Therapy: Divide daily tasks to small parts and start with minimal activity, Avoid push/crush cycles
84
Chronic Fatigue Sd 4 medications that "might be" helpful 1,2 Mg, NADH 3,4 ?
Vit D L carnitine
85
Chronic Spasticity 1st line Tx
Baclofen
86
Chronic Spasticity Baclofen SEs 1. Highly sedative 2. .........
If suddenly discontinued: Confusion, Seizures, Hallucinations
87
Chronic Spasticity 2nd line Tx
Tizanidine (Alpha2 Agonist) (SEs: Dry mouth, drowsiness)
88
Chronic Spasticity Alternative Tx: For nighttime symptoms?
Diazepam or Clonazepam
89
Chronic Spasticity Alternative Tx: 1. If associated with neuropathy: Gabapentine 2. If associated with MS and pain?
Sativex (THC buccal Spray)
90
Chronic Spasticity If Focal?
Injection of Phenol every 6 months Or Injection of Botox every 3 months
91
Fibromyalgia Only two drugs are approved in Canada: 1.......... 2.........
Duloxetine Pregabaline (Preferably low dose)
92
Fibromyalgia Tx in Pregnancy
Preferably nonpharma Duloxetine is ok But Pregabaline is NOT safe
93
Fibromyalgia Nonpharma: ..........., CBT, Massage, TENS, Education, Meditation, Acupuncture
GAE Graded Aerobic Exercises
94
Muscle Cramps If severe and not iatrogenic, Tx?
Quinine Sulfate for 4-6 weeks (Never longer than 3 months)
95
Muscle Cramps Quinine Sulfate: Monitoring ? Other SEs ? (3)
Bleeding because of thrombocytopenia Other SEs: Arrhythmia, SJS, Vasculitis
96
Muscle Cramps Tx in Pregnancy
Mg 2-4 weeks
97
Persistent Hiccups (2-30 days) 1st line Tx
Chlorpromazine IV 25-50 mg IV slowly within 30 min in ER (Sometimes Oral trial)
98
Persistent Hiccups 2nd line Tx 3rd line Tx
2: Haloperidol IM or Oral 3: Metoclopramide IV or Oral
99
Intractable Hiccups (over 1 month) Tx
Baclofen (Then taper slowly)
100
Restless Leg Sd 1st Line if Intermittent type
Levodopa/Carbidopa Or BZP Or Codeine (low potency opioid)
101
Restless Leg Sd 1st Line if chronic persistent type
Pramipexol or Ropinirol (Dopamine agonists) Or Pregabaline
102
Restless Leg Sd Chronic Persistent type: a transdermal patch?
Ritogotin (Dopamine Agonist)
103
Restless Leg Sd Tx in Pregnancy or Breastfeeding
No dopaminergic No GABA But BZP or Opioids are not contraindicated
104
Neuropathic Pain Acute pain in Herpes Zooster (Shingles)
Acyclovir Oral +|- Gabapentin or Amitryptyline
105
Neuropathic Pain Chronic Radiculopathies
Acetaminophen/ Codeine/ NSAIDs
106
Neuropathic Pain Chronic Peripheral Neuropathies 1st line Tx
TCA or GABA
107
Neuropathic Pain Chronic Peripheral Neuropathies 2nd line Tx 3rd line Tx
2. SNRI or Lidocaine 3. Opioids (Preferably transdermal or SR)
108
Neuropathic Pain In Pregnancy
No GABA, No Carbamazepine Caution with Opioids Others are +|- ok
109
Neuropathic Pain In Breastfeeding
No GABA, No BZP Caution with Opioids, Others are ok
110
Neuropathic Pain Relative CIs for Opioids (5) - Hx of addiction - Frequent Migraine - Fibromyalgia ............, ...........,
Tensions Headache Psychosomatic pains
111
Gout Nonpharma Avoid: liver, kidney, ......, alcohol, high fructose foods, beef, lamb, pork, ......., gravies, desserts, sweetened beverages, high fat diaries
Sweet breads, Sardine, Shellfish
112
Gout Allopurinol Hypersensitivity Sd (AHS) may result in SJS or TEN. Three Risk factors ?
Thiazides Renal Dysfunction Starting with high doses
113
Gout Chronic Phase: If renal function is impaired, Tx?
Febuxostat (But it may increase liver enzymes)
114
Gout Three rules for Uricosurics like Probenecid or Losartan
1. Not 1st line 2. No monotherapy 3. Not recommended if ClCr \< 50 or if hx of renal stones
115
Gout Alluporinol interactions: - Increases risk pf rash with Amoxicillin - ............
Inhibits hepatic metabolism of Warfarin (Bleeding)
116
Gout Colchicine interaction
May increase myopathy with Statins
117
Headache Triptans CIs (3) -Cardiac diseases ........., .........
HTN Basilar or hemiplegic Migraine
118
Headache, Acute Phase 1st line Acetaminophen, ASA, NSAIDs 2nd .........
DHE Spray or Oral Triptans
119
Headache Prophylaxis CCBs: Verapamil or ..........
Flunarizine (CI: hx of depression)
120
Headache In Pregnancy
Ergot derivatives: CI Triptans: CI Other: +|- ok
121
Headache in Children: watch for ....... when prescribing 1st line meds
ASA and Reye Sd
122
Headache in Children Prophylaxis: In younger children? In others?
Y: Cyproheptadine O: Flunarizine (CCB), (watch for depression)
123
Headache in Children The Only approved treatment for acute headache in 12-18 yo (in Canada)
Almotriptan
124
Headache Prophylaxis for Migraine around menses
Triptans Start 2 days before menses, Continue for 1 week
125
MS 1st Line Tx (2)
Glatiramer, Interferon beta
126
MS Serious SEs: Glatiramer: is usually well tolerated, Interferon beta?
Rare: Severe Hepatotoxicity
127
MS Serious SEs: Alemtuzumab?
Autoimmunity often in thyroid
128
MS Serious SEs: Dimethyl Fumarate (2)
Pr Uria Increased Liver Enzymes
129
MS Serious SEs: Fingolimod Monitoring
Regular LFT
130
MS Serious SEs: Mitoxantrone (2)
Cardiotoxicity Leukemia
131
MS Serious SEs: Natalizumab
PML (Progressive Multifocal Leukoencephalopathy)
132
MS Serious SEs: Teriflunomide Caution
CI in Pregnancy And washout is needed
133
MS In Canada, ......... is approved for gait disturbances in MS (Adjunctive Tx)
Fampridine
134
MS Vit D?
Recommended 1000 IU daily To all patients
135
Seizures DOC in Focal (Partial) Seizures, Including Simple and Complex
Carbamazepine
136
Seizures DOC in Generalized Seizures: 1. Petit mal: Ethosuximide 2. Grand mal? 3. Atonic? 4. Myoclonic?
All: Valproate
137
Seizures Monitoring for Valproate (2)
CBC for Plts LFT (and Not recommended for women in fertility ages)
138
Seizures Most of antiepileptic medications are enzyme inducers, except for ........
Valproate Which is Inhibitor
139
Antiepileptics SEs - Vigabatrin ? - Levetiracetam?
- V: Visual field defects - L: Psychiatric SEs
140
Carbamazepine Serious SEs (2)
Cardiac Conduction disturbances Neutroenia
141
Phenytoin Serious SEs (3) 1. Gyngival Hypertrophy 2. Coarse facies 3. ..........
Folate deficiency
142
Headache Migraine Prophylaxis 1. Beta blocker 2 to 6 ?
Valproate, Topiramate, Verapamil, Lithium, Flunarizine
143
Headache Cluster headache Prophylaxis 1. Verapamil 2,3 ?
Lithium Flunarizine
144
Headache Cluster: Acute Attack ................. or ............. or High flow Oxygen or Intranasal lidocaine
Sumatriptan Or Dihydroergotamine
145
Headache Migraine Acute Attack 1st line Acetaminophen or ASA +|- Caffeine 2nd line NSAIDs 3rd line ..........
5HT Agonists (Sumatriptan) +|- Antiemetic
146
Parkinson's disease Recommended medications based on age:
Above 60 yo: Start with Levodopa/ Carbidopa Below 60 yo: Start with Ropinirol/ Pramipexol
147
Parkinson's disease Four SEs of Levodopa/ Carbidopa 1. On/Off 2. ......... 3........... 4...........
2. Peak-dose dyskinesia 3. Off period dystonia 4. Diphasic dyskinesia
148
Parkinson's disease Why is Bromocriptine less commonly used?
Pulmonary Fibrosis
149
Parkinson's disease SEs of Ropinirol/ Pramipexol/ Bromocriptine 1. Sleepiness during the day 2. Impulse control problems 3. ............
Psychiatric: Hallucinations, Confusion (and GI, Ortho-Hypo)
150
Parkinson's disease Transdermal patch
Rotigotine
151
Parkinson's disease MAO-B Inhibitors: Example............ Indication...........
Selegiline Only initial Tx in mild Parkinson's
152
Parkinson's disease: NMDA Antagonist: ............. SEs: 1. Edema 2. Erythema 3............
Amantadine 3. Livedo reticularis
153
Parkinson's disease: Amantadine Indication: Movement Disorders with Levodopa Two CIs ?
1. Cognitive disorder 2. Confusion
154
Parkinson's disease: Anticholinergics: THF, Benztropine Indication..........
Only effective on tremor at rest
155
Parkinson's disease COMT Inhibitors, example......... Indication..........
Entacapone Only with Levodopa for wearing off
156
Parkinson's disease COMT Inhibitors: Entacapone SE (1)
Urine color change (benign)
157
Parkinson's disease If we abruptly discontinue dopamine agonists, .......... might happen.
Parkinsonism Hyperpyrexia Sd. (Similar to NMS)
158
Low back pain If acute: watch for Red Flags Example: Epidural Abcess? IV drug abuser, Fever, ........, ........,
Pain which is not related to position, Sensory, motor problems
159
Low back pain If a pregnant woman needs imaging?
MRI (without Contrast)
160
Neck pain and Whiplash WAD Classification: WAD 1. Only pain, WAD 2. .........., WAD 3. .........., WAD 4. Fx or Dx or Instability
2. ROM is decreased 3. Sensory or Motor or Reflex deficit
161
Neck pain and Whiplash Bone and Joint Classification: BJ 1. NL activity is ok BJ 2. .......... BJ 3. .......... BJ 4. Structural lesion
2. NL activity is impaired 3. Neurological findings
162
Neck pain and Whiplash Nonpharma: WAD 1,2: ........... WAD 3: ......... WAD 4: Urgent refer
1,2: symptomatic Tx, no collar, no immobilization 3: rest + semi-hard collar for 3-6 weeks
163
Sport Injuries Nonpharma Tx
RICE Protocol Rest/ Ice: 20 min QID/ Compress/ Elevation
164
Sports Injuries Local injection of Triamcinolone is a good choice in most of sports injuries, except for: 1......... 2........
Patella, Achilles
165
Sports Injuries Nitroglycerin patch may be used in .........
Chronic pains 1/4 of a patch per day, Regularly change the site
166
Sports Injuries Platelet Rich Plasma (PRP) May be used in: 1. ........ 2 ......
Elbow, Achilles
167
Sports Injuries: Ankle Sprain Tx: Grade 1,2: Rice, Symptomatic Tx Grade 3: ?
G3: Removable cast brace If no response after 6-8 weeks, then refer
168
Giant Cell Arthritis (Temporal Arthritis) 1st line?
Prednisone Oral ASAP 40-60 mg daily
169
Polymyalgia Rheumatica 1st line Tx
Prednisone Oral 10-20 mg daily
170
In PMR and in GCA, our long term management includes: 1. Bisphosphonates 2. Ca, Vit D 3. ..........
Try to decrease dosage of Prednisone to less than 7.5 mg daily
171
Osteoporosis Nonpharma Tx 1. Ca, Vit D, decrease alcohol 2. Smoking Cessation 3. ........ 4. ........
3. Regular impact type exercise 4. Decrease falls risk in elderly
172
Osteoporosis DOC if Osteoporosis is secondary to CS
Bisphosphonates
173
Osteoporosis Two best Bisphosphonates 1. Alendronate 2. ........
Residronate (Both are Oral)
174
Osteoporosis Bisphosphonates: ............... IV is only used once in a year
Zoledronate
175
Osteoporosis Bisphosphonates SEs 1. Esophagitis or Ulcer 2. AFib 3. ......... 4..........
3. ONJ Osteonecrosis of the Jaw 4. AFSF Atypical Femoral Shaft Fx
176
Osteoporosis a drug that works through RANK receptor
Denozumab
177
Osteoporosis SERMs: Raloxifen SE? (1)
VTE
178
Osteoporosis A possibly good candidate for HRT?
Recently menopause with severe hot flushes
179
Osteoporosis Anabolics (PTH Analogues) Example......... (Max: for 2 years) Possible SE..........
Teriparatide Possible Osteosarcoma (Daily SC injection)
180
Rheumatoid Arthritis MTX, SEs: 1. Stomatitis 2. Abortogenic 3. Teratogenic 4............. 5.............
4. Hepatotoxic 5. Pneumonitis
181
Rheumatoid Arthritis MTX should be prescribed with.......
Folic Acid or Folinic Acid (8-12h later)
182
Rheumatoid Arthritis Hydroxychloroquine, SEs: 1. .............. 2. Severe Hypoglycemia
Retinal Deposition Monitoring: eye exam once a year
183
Rheumatoid Arthritis Sulfasalazine, SEs: Hepatotoxicity - ......... , ..............
- Hemolytic anemia - - Reversible Oligospermia
184
Rheumatoid Arthritis Leflunomide SE ?
Hepatotoxic (avoid alcohol, avoid MTX)
185
Rheumatoid Arthritis Biological Treatments: 1- monitor for latent TB 2- Discontinue in time of infection or surgery 3- with live vaccinations?
No live vaccines
186
Rheumatoid Arthritis DOC in Pregnancy
CS is the safest (No MTX, Leflunomide, biological)
187
SLE Tx for Malar rash or discoid rash?
Topical CS or Topical Tacrolimus
188
SLE ASA and NSAIDs are used to treat serositis. Why shouldn't we use high doses?
They increase the risk of aseptic meningitis if prescribed high dose
189
SLE Intervals needed to Pregnancy - MTX: 3-6 months - Micophenolate: ............ Leflunomide ............
- Mic: 6 weeks - Lef: 11 days washout
190
SLE DOC in Pregnancy
Chloroquine or CS
191
SLE Why should we avoid SMX/TMP?
Increases rashes Or causes flares
192
SLE Azathioprine Monitoring
CBC weekly for 1 month (Leukopenia or thrombocytopenia) + LFT and Cr monthly
193
SLE Micophenolate Monitoring
CBC weekly for 1 month (Anemia, Leukopenia or thrombocytopenia) + LFT and Cr monthly