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TDM > TDM Drugs > Flashcards

TDM Drugs Flashcards

1
Q

Dosage forms of carbamazepine

A

Oral

Rectal

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2
Q

Maintenance dose of carbamazepine for epilepsy

A

Initially 100 to 200mg BD orally increased gradually to a max of 1.6-2g/day

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3
Q

Time to reach steady state for carbamazepine

A

> 2 weeks when initiating therapy

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4
Q

Therapeutic range for carbamazepine

A

4-10mg/l

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5
Q

Toxic effects of carbamazepine

A 
Incoordination 
Blurred vision 
Diplopia
Drowsiness
Nystagmus
Ataxia 
Arrhthmias 
Nausea and vomiting 
Diarrhoea 
Hyponatraemia
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6
Q

Major route of elimination for carbamazepine

A

98% hepatic

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7
Q

Which two drugs can decrease levels of carbamazepine

A

Phenytoin

Phenobarbital

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8
Q

Name 5 drugs that can increase levels of carbamazepine

A 
Erythromycin
Cimetidine 
Diltiazem
Verapamil 
Isoniazid
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9
Q

True or false: carbamazepine induces its own metabolism

A

TRUE- this is why any changes in dose will take approx 1 week to produce a new steady state concentration

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10
Q

Dosage forms of ciclosporin

A

Oral

IV infusion

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11
Q

Toxic effects of ciclosporin

A 
Nephrotoxicity 
Hepatotoxicity 
Muscle tremor 
Nausea 
Gingival hyperplasia 
Hypertension
Hyperkalaemia
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12
Q

True or false: it does not matter if you change brands of ciclosporin

A

FALSE - stick to same brand due to different bioavailabilities

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13
Q

Dosage forms of digoxin

A

Oral

Intravenous infusion

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14
Q

Time to steady state for digoxin

A

1 week with normal renal function

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15
Q

Therapeutic range of digoxin

A

1-2 mcg/L

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16
Q

Toxic effects of digoxin

A 
Nausea 
Vomiting 
Arrhythmias
Visual disturbances 
Weakness 
Lethargy
17
Q

Loading dose of gentamicin

A

3mg/kg IBW

18
Q

Time to steady state for gentamicin

A

12 to 24 hrs

19
Q

Therapeutic range for gentamicin

A

Peak: 5mg/kg-12mg/kg
Trough: <2mg/L

20
Q

Toxic effects of gentamicin

A

Otoxicity

Nephrotoxicity

21
Q

Major route of elimination for gentamicin

A

Renal excretion

22
Q

Major route of elimination for digoxin

A

Excreted unchanged in the urine. Hepatic metabolism to active metabolites

23
Q

Maintenance dose of lithium

A

500- 1200mg/day

24
Q

Lithium time to steady state

A

4-7 days

25
Q

Therapeutic range of lithium

A

0.4 to 1mmol/l

26
Q

Toxic effects of lithium

A 
Nausea
Vomiting 
Diarrhoea 
Weight gain 
Hand tremor 
Slurred speech 
Irritability 
Stupor
Seizures
Nephrotoxicity 
Increased reflexes
27
Q

Elimination half life

A

18-36 hours

28
Q

Major route of elimination for lithium

A

Freely filtered at glomerulus with 80% reabsorbed. No metabolism

29
Q

Volume of distribution for lithium

A

0.8L/kg

30
Q

7 factors that can increase plasma conc of lithium

A 
Renal impairment 
Diuretics 
ACEI
ARBs
NSAIDs
Hyponatraemia 
Intercurrent infection
31
Q

Three things that can decrease plasma conc of lithium

A

Theophylline
Acetazolamide
Cisplatin

32
Q

Should lithium be prescribed by brand

A

Yes

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