Therapeutic drug monitoring

Question 1

Digoxin treatment effect on ECG

Answer 1

down-sloping ST segment in all leads

Question 2

Monitoring of statins
1. parameters monitored
2. frequency

Answer 2

1. LFT
2. baseline; 3 mo; 12 mo

Question 3

Monitoring of ACE inhibitors
1. parameters monitored
2. frequency

Answer 3

1. U&Es
2. baseline + annually + after incr dose

Question 4

Monitoring of amiodarone
1. parameters monitored
2. frequency

Answer 4

1. TFTs, LFTs; U&Es and CXR only prior to treatment
2. all prior to tx; TFT and LFTs only every 6mo

Question 5

Monitoring of methotrexate
1. parameters monitored
2. frequency

Answer 5

1. FBC, LFT, U&Es
2. baseline; weekly until therapy stabilised; 2-3 mo after stabilized

Question 6

Monitoring of azathioprine
1. parameters monitored
2. frequency

Answer 6

1. FBC, LFT
2. both baseline; FBC only weekly for 4 weeks; then both every 3 mo

Question 7

Monitoring of lithium
1. parameters monitored
2. frequency

Answer 7

1. Lithium level, TFT, U&Es
2. TFT and U&Es baseline
   lithium weekly until stabilized then every 3mo
   TFTs and U&Es every 6mo

Question 8

Monitoring of sodium valproate
1. parameters monitored
2. frequency

Answer 8

1. LFT
2. LFT (+FBC) baseline; LFT ‘periodically’ during first 6mo