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Drug monitoring Flashcards

1
Q

What should you monitor for these drugs

  1. statins
  2. vanc & gent
  3. cOCP & HRT
  4. amiodarone
  5. ACEi
  6. digoxin
  7. valpotare
  8. cloazapine
  9. DKA treatments
  10. SSRIs
  11. pneumonia treatment
  12. O2 therapy & aminophyline
  13. allopurionl
  14. IV fluids
  15. lithium
A
  1. ALP or CK
  2. renal function (creatinine)
  3. BP
  4. baseline CXR
  5. U&Es
  6. renal function (creatinine)
  7. LFTs (e.g. ALT)
  8. FBC
  9. ketones
  10. suicidal thougths
  11. RR
  12. o2 sats
  13. urate
  14. BP
  15. renal function
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2
Q

what should you usually monitor for a drugs ‘therapeutic effect’

A

Like vital signs & shit

Not gonna be a drug’s concentration

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3
Q

what to you monitor in statins

A

Sore muscles -> CK

no sore muscles -> ALP

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4
Q

Does digoxin fuck your kidneys or liver

A

kidneys

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5
Q

what investigation do you need to do before starting amiodarone

A

CXR

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6
Q

for monitoring SSRIs, what should you check after 2 weeks and 4 weeks

A

2 weeks -> rash

4 weeks -> suicial thoughts

obvs it takes like 4-6 weeks to kick into action

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7
Q

if the level of a drug is below what it shoudl be, but the pt is seeing benefits from it, what should you do?

A

Nothign mate

therapeutic index is most important

if it works for them, then happy days eh cheeeeers

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8
Q

when should you monitor gent

A

8hrs post-dose

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9
Q

if you’re unsure what to monitor, what should you check for

A

Common/seriour SEs eh

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10
Q

Gent levels

What should these be & what shoudl you do if not right

Peak level

Trough level

A

Peak level

Normal -> 5-10

IE -> 3-5

Change the dose if abnormal

Trough level

Normal -> <2

Chaneg dose interval if abnormal

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11
Q

for the benefical effecets of anti-hypertensives, what should you monitor

A

HR

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12
Q

what is the normal range of lithium

A

0.4 -> 1

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13
Q

when should you do blood test for a paracetamol OD

A

4hrs after taking it

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14
Q

Warfarin shite & INR

What shoudl you do if a pt on warfrain has the following INR results…

  1. 5-6
  2. 6-8
  3. >8
A
  1. Decrease dose
  2. stop for 2 days, start again at lower dose
  3. stop & give Vit K
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15
Q
A
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16
Q

Signs of toxicity -> probs should monitor eh

  1. lithium
  2. digoxin
  3. phenytoin
  4. Gent & vanc
A
  1. tremors -> tierdness -> arrythmias, coma, seizure
  2. bradycardia, ‘halos’ in vision, confusion, arrythmia
  3. sore gums, ataxia, peripehral nueropathy
  4. hearing loss & AKI
17
Q

What are the early, mid, and late signs of lithium toxicity?

A

Early -> tremor & diarrhoea

Mid -> tierdness

late -> confusion, coma & arrythmias

18
Q

If the levels of a drug are in the normal range, can it be an OD

A

Obvs fucking not

Pt can be allergic to it tho lol

19
Q

what drugs increase the risk of lithium toxicity?

A

ACEi & diuretics

reduce lithoum excretion eh

20
Q

lets say a pt is being given too much paracetamol as a result of being prescribed both paracetamol and co-codamol

if they are still in pain, which one should you stop?

A

paracetamol

probs need the extra strength of the co-codamol

21
Q

what bit in the BNF can tell you about tests to fo before starting treatment

A

pre-treatment screening

22
Q

what needs to be monitored after a blood transfusion

A

Heart rate, blood pressure and temperature

23
Q

how do you monitor the beneficila effects of B-blockers & digoxin

Fucking hell, for all anti-hypertensives and anti-arrythmics

A

HR

24
Q

for anti-psychotics, what do you need to monitor after a week

A

Weight

BMI

25
Q

what do you monitor for insluin-glucose infusions

A

BG

who would’ve fucking thought eh

26
Q

for thryoid drugs like carbimazole, what do you monitor after 6 weeks

A

TFTs ehhhhhh

27
Q

whats good to monitor after like 4 days of ABXs

A

CRP

See if the infection has gone down eh

28
Q

what do you monitor 30mins after starting oxygen therapy

A

ABGs

29
Q

what do you monitor after getting fluids

A

HR & BP

30
Q

whats best way to monitor the therapeutic benefit of diuretics

A

WEIGHT

31
Q

if TSH are stable, when should you do TFTs?

A

Once a year mate

32
Q

how do you monitor for advsere effects of heparin

A

FBC

33
Q

if you get LFTs and there’s statins involved, what would you do to the dose

A

Probs just fucking leave it yeah

34
Q

what test to you do to check that you’re getting the right dose of warfarin

A

INR

35
Q

what tests to you do to monitor contraceptives

A

Weight & BP

36
Q
A
37
Q

what do you monitor for the benedicial effects of diuretcis

A

weight

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