Drug monitoring

Question 1

Statins: details of monitoring

Answer 1

LFTs

Baseline
3 months
12 months

Question 2

ACEis:

Answer 2

U&Es
Prior to treatment
U&E after increasing dose
U&E at least annually

Question 3

Amiodarone

Answer 3

TFT, LFTs
TFT, LFT, U&Es CXR prior to treatment

TFT, LFT every 6 months

Question 4

Methotrexate

Answer 4

FBC, LFT, U&Es
Before tretment and weekly till stabilised then every 3 months

Question 5

Azathioprine

Answer 5

FBC, LFT
before treatment
Weekly for the first 4 weeks
FBC, LFT every 3 months

Question 6

Lithium

Answer 6

Lithium level, TFT, U&E
Prior to treatment TFT and UEs -> 6 monthyl
Lithium level weekly till stabilised then every 3 months

Question 7

Sodium Valproate

Answer 7

LFT
LFT, FBC before treatment
LFT periodically during first 6 months

Question 8

Glitazones

Answer 8

LFT before and regularly during treatment

Question 9

Therapeutic drug monitoring: Lithium level

Answer 9

Take 12 HOURS post dose

Question 10

Ciclosporin

Answer 10

Trough levels immediately before dose

Question 11

Digoxin - only in suspected toxicity

Answer 11

at least 6 hours post dose

Question 12

Vancomycin - parameter to assess

Answer 12

Renal function

Question 13

Statins - when to stop with regards to LFT

Answer 13

If ALT > 105 3X upper limit
Marked rise in CK or symptoms

Question 14

ACEis what to measure for beneficial effects:

Answer 14

Exercise tolerance

Question 15

Methotrexate: when to avoid

Answer 15

Hepatic or renal dysfunction

Question 16

Antipsychotics: Olanzapine monitoring

Answer 16

Fasting blood glucose

Question 17

Antipsychotics: clozapine monitoring

Answer 17

FBC every week for first 18 weeks (agranulocytosis)

Question 18

Digoxin - what to measure.

Answer 18

Creatinine (renal function)