Therapeutic Drug Monitoring and Data Interpretation Flashcards
On ECG, hypokalemia —> reverse tick(ice cream scoop)phenomena –
you get with DIGOXIN TOXICITY
-take digoxin level 6 hour post dose
DIGOXIN TOXICITY
- Classic reverse tick sign on ECG
-Digoxin toxicity worsened in the states of hypokalemia
-Digoxin levels should be taken at least 6 hours post dose
-Close monitoring of U&E when prescribing digoxin with diuretics
-Ensure magnesium levels are added to bloods if K is low, Mg likely to be low
Carbimazole
For hypothyroidism
May cause acute pancreatitis(lipase)
!may cause NEUTROPENIA AND AGRANULOCYTOSIS
!may cause CONGENITAL MALFORMATIONS with use during pregnancy
other drugs to cause agranulocytosis : phenytoin and clozapine
With atorvastatin, what is the amount that needs to be increased in order to consider stopping it?
If higher than 3 times than high limit
Side effect of atorvastatin
If CK markedly elevated and we think statin is contributing, hold statin, recheck CK.
If symptoms resolve and CK went back to normal than can reıntroduce statin/ alternative statin/reduced dose and monitor closely
Azathioprine
Pre-treatment screening - Thiıpourine methyltransferase
Amiodorone Monitoring
may cause thyroid problems
Amiodorone induced
BLUE MAN SYNDROME
Poisoning emergency treatment
CHECK ON BNF
LITHIUM – NAUSEA, TREMORS CHECK FOR URGENT LI LEVELS IN BLOOD
HYPONATREMIA
Cuation on rate of Na increase in 24 hours –> no more than 10 mmil/L increase in 24 hours
If on PPI –> switch to famotidine
Hold diuretics
Review fluids and electrolytes treatment summary
Asthma, acute
Treatment summary
Clopazine
first weekly monitoring bloods then increase
Psxyhoses and related disorders
-Extrapyramidial symptoms and hyperprolactinemia
Hy
