HIGH Risk Flashcards
(20 cards)
What are the key toxicity symptoms and monitoring requirements for Lithium?
Toxicity Symptoms: Tremor, ataxia, slurred speech, confusion, seizures, GI upset
Monitoring: Trough serum lithium (0.4–1.0 mmol/L), U&E, TFTs, calcium every 6–12 months
Notes: Narrow therapeutic index; check levels 12 hours post-dose
How can toxicity of Phenytoin be identified and managed?
Toxicity Symptoms: Nystagmus, ataxia, slurred speech, diplopia, confusion, hypotension (IV)
Monitoring: Plasma phenytoin levels (10–20 mg/L), LFTs, albumin, FBC
Notes: Non-linear kinetics; protein binding affects levels
What are the signs of Digoxin toxicity and how is it monitored?
Toxicity Symptoms: Nausea, visual changes (yellow halos), confusion, bradycardia, arrhythmias
Monitoring: Serum digoxin (0.5–2.0 ng/mL), renal function, electrolytes (K+, Mg2+)
Notes: Hypokalaemia increases toxicity risk
What toxicity signs are associated with Theophylline and what monitoring is needed?
Toxicity Symptoms: Nausea, vomiting, tremor, seizures, arrhythmias
Monitoring: Serum level (10–20 mg/L), LFTs, smoking status
Notes: Multiple interactions; narrow therapeutic range
What should be monitored with Gentamicin therapy and why?
Toxicity Symptoms: Ototoxicity (tinnitus, hearing loss), nephrotoxicity
Monitoring: Trough and peak serum levels, renal function
Notes: Avoid prolonged use; dose-adjust in renal impairment
What monitoring is essential for Amiodarone, and what toxicities may occur
Toxicity Symptoms: Pulmonary fibrosis, thyroid dysfunction, hepatotoxicity, photosensitivity
Monitoring: TFTs, LFTs, CXR, ECG every 6 months
Notes: Long half-life; multiple drug interactions
What are the adverse effects and monitoring needs of Vancomycin?
Toxicity Symptoms: Nephrotoxicity, ototoxicity, Red man syndrome
Monitoring: Trough levels (10–20 mg/L), renal function
Notes: Slow infusion reduces histamine release
Why is monitoring important for Methotrexate, and what are its toxicity risks?
Toxicity Symptoms: Myelosuppression, hepatotoxicity, mucositis, pulmonary toxicity
Monitoring: FBC, LFTs, U&E (1–2 weeks initially, then 2–3 monthly)
Notes: Weekly dosing; co-prescribe folic acid
What are the monitoring requirements for Warfarin, and how is bleeding risk managed?
Toxicity Symptoms: Bleeding, bruising, haematuria, GI bleeding
Monitoring: INR (target 2–3 or 2.5–3.5 depending on indication)
Notes: Vitamin K antagonist; many interactions
What toxicity risks are associated with Clozapine, and what monitoring is required?
Toxicity Symptoms: Agranulocytosis, myocarditis, seizures, constipation
Monitoring: Weekly FBC (first 18 weeks), then monthly; weight, lipids, BP
Notes: Educate patient on infection signs; register with monitoring service
What are the risks and monitoring requirements for Carbamazepine?
Toxicity Symptoms: Ataxia, diplopia, hyponatraemia, rash, blood dyscrasias
Monitoring: LFTs, FBC, sodium
Notes: Autoinduction affects plasma levels; interactions common
What toxicity effects does Sodium Valproate have and how is it monitored?
Toxicity Symptoms: Hepatotoxicity, pancreatitis, thrombocytopenia, tremor
Monitoring: LFTs, FBC regularly
Notes: Teratogenic; avoid in pregnancy
What are the safety concerns and monitoring needs for Azathioprine?
Toxicity Symptoms: Myelosuppression, hepatotoxicity, pancreatitis
Monitoring: TPMT before starting; FBC, LFTs every 1–3 months
Notes: Stop if WBC drops or signs of infection
What are the adverse effects of Methadone and how should it be monitored
Toxicity Symptoms: Respiratory depression, QT prolongation
Monitoring: ECG for QT interval, signs of overdose
Notes: Long half-life; accumulation risk
What toxicities are associated with Tacrolimus, and what monitoring is needed?
Toxicity Symptoms: Nephrotoxicity, hyperglycaemia, hypertension, tremor
Monitoring: Trough levels, renal function, glucose, BP
Notes: Narrow therapeutic window; avoid grapefruit juice
What are the key monitoring parameters for Flucloxacillin, especially during prolonged use?
Toxicity Symptoms: Cholestatic hepatitis
Monitoring: LFTs if prolonged use
Notes: Safe short-term; caution >14 days
What adverse effects are linked to Rifampicin and what should be monitored?
Toxicity Symptoms: Hepatotoxicity, orange discolouration of fluids
Monitoring: LFTs regularly
Notes: Potent enzyme inducer; check drug levels
What makes Linezolid use high risk, and what should be monitored?
Toxicity Symptoms: Myelosuppression, optic neuropathy, serotonin syndrome
Monitoring: Weekly FBC, visual symptoms if prolonged use
Notes: Avoid SSRIs to prevent serotonin syndrome
What is the risk of toxicity with Fluorouracil (5-FU) and how is it monitored?
Toxicity Symptoms: Diarrhoea, mucositis, hand-foot syndrome, cardiotoxicity
Monitoring: FBC, renal and liver function tests, cardiac symptoms
Notes: Increased toxicity with DPD enzyme deficiency
