Drug monitoring Flashcards
1
Q
which test is most important before starting vancomycin
A
serum creatinine
- vancomycin clearance is reduced in patients with renal dysfunction
- nephrotoxicity and ototoxicity
2
Q
which test is most important before starting statins
A
Serum ALT
- statins are metabolised by the liver and therefore liver function should be measured befrore
- should also be checked 3 and 12 months after starting treatment
3
Q
lithim
A
- lithium sampling should take place 12 hours after last dose
- normal range is 0.4-0.8mmol/L - toxicity would be clear if >1.5mmol/l
- FBC should be checked before commencement
- UEs and thyroid function
- serum lithium monitoring should take place weekly after initiation untill stable, then every 3 months and after dose changes
- patients should avoid making changes to sodium intake because sodium depletion cna increase risk of lithium toxicity
4
Q
methotrexate
A
- FBC should be measured every 2-3 months once therapy is stabilised
- should not be commenced if liver functions are abnormal
- renal monitoring required
5
Q
olanzapine
A
- prolactin
- weight
- lipids
- fasting blood glucose
6
Q
amiodarone
A
- T3 and T4 should be measured
- baseline chest x-ray
- monitor liver function
- renal function dose not need to be measured
7
Q
carbimazole
A
- ## FBC required inc neutrophil -> can cause neutropenia - sore throat bad sign
8
Q
gentamicin
A
- for a multiple daily dose regime, 1 hour (peak) serum conc should be 3-5mg/l
- trough levels shold be <1mg/l
- monitoring of renal function in those with renal dysfunction
9
Q
digoxin
A
- For plasma-digoxin concentration assay, blood should be taken at least 6 hours after a dose.
serum creatinine
10
Q
sodium valproate
A
- associated with hepatotoxicity - measure ALT baseline and at regular intervals
11
Q
clozapine
A
- FBC due to agranulocytosis
- should be registered with a clozapine monitoring service
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