Toxicity Side effects

Question 1

When to monitor for Lithium

Answer 1

weekly until stable
—> every 3 months (year 1)
——-> every 6 months

Question 2

When do you record Lithium serum concentration

Answer 2

12 hours after dose

Question 3

Signs of Lithium Toxicity
SICK and TREMOR

Answer 3

• nausea
• tremor
• increased weeing/thirst
• headache

Question 4

What organ is not affected by lithium

Answer 4

Liver

Question 5

What is the therapeutic range for Digoxin

Answer 5

0.7 to 2

Question 6

When should Digoxin samples be taken

Answer 6

6 hours after dose

Question 7

What are the signs of Digoxin toxicity apart from Yellow vision

Answer 7

• sick
• confused
• palpitations

Question 8

What is a rare syndrome you should not give digoxin with

Answer 8

Wolff-Parkinson-White Syndrome

Question 9

What can be a sign of bone marrow toxicity when taking methotrexate

Answer 9

Mucositis (inflammation of mouth of gut)

Question 10

What requires discontinuation of methotrexate

Answer 10

• pulmonary toxicity
• bone marrow supression/neutropenia
• Diarrhoea
• Oral mucositis

Question 11

What should be monitored in methotrexate

Answer 11

• blood
• renal
• liver

Question 12

When should Methotrexate monitoring take place

Answer 12

• every 1 to 2 weeks until stable
  —-> every 2 to 3 months

Question 13

What should the monitoring frequency be for Methotrexate when taking Leflunomide

Answer 13

monthly for 12 months

Question 14

What should be monitored with Warfarin

Answer 14

• FBC
• LFT
• renal
• BP
• thyroid

Question 15

What are signs of toxicity for Theophylline
SICK and FAST

Answer 15

• Nausea
• tremor
• palpitations
• hyperglycaemia

Question 16

What to not have with Phenytoin

Answer 16

• Enteral feeding (stop it 2 hours before and after dose)

Question 17

What supplements might be needed for when taking Phenytoin

Answer 17

Vitamin D

Question 18

When to stop Phenytoin

Answer 18

if rash appears

Question 19

When to discontinue ciclosporin

Answer 19

• uncontrolled hypertension
• peripheral neuropathy
• hair loss
• rash

Question 20

What is the interaction of statins and cyclosporin

Answer 20

myopathy

Question 21

When to measure serum concentration of gentamycin

Answer 21

after 3rd or 4th dose

Question 22

What are the serum ranges for Vancomycin

Answer 22

10 to 20

Question 23

What are the signs of toxicity of vancomycin

Answer 23

• sore throat
• brusing
• mouth ulcers

Question 24

How long after treatment does amiodarone still incur side effects

Answer 24

several weeks to months

Question 25

What can amiodarone do to neonates

Answer 25

goitre (swelling of thyroid glands in neck)

Question 26

Can you breast feed with amiodarone

Answer 26

NO

Question 27

What is a long term affect of Heparins

Answer 27

Osteoporosis

Question 28

What cyclophosphamide cause and how to treat it

Answer 28

haemorrhagic cystitis

(treated with mensa)

Question 29

What is cyclophophammide induced hemorrhagic cystitis

Answer 29

inflammation and bleeding from bladder lining

Question 30

How long post cyclophosphamide treatment should contraception go on for, for each gender

Answer 30

Females (12 months)

Males (6 months)

Question 31

Hypoglycaemia effects

Answer 31

• palpitations
• rapid heart beat
• sweating

Question 32

What are the interactions of Sulfonylureas

Answer 32

• BB
• NSAIDs
• Alcohol