Interpretation of chronic disease monitoring Flashcards
(17 cards)
What is monitoring in terms of prescribing?
Monitoring includes therapeutic monitoring, toxicity assessment, symptom control, compliance checks, and dose adjustments.
What is the purpose of monitoring?
Monitoring increases patient safety, reduces avoidable hospital admissions, improves adherence, and allows better treatment selection.
What are the downsides of monitoring?
Downsides include inconvenience, costs, false positives/negatives, and the need for appropriate actions after abnormal results.
What chronic conditions do we monitor in primary care?
Conditions include asthma, COPD, diabetes, hypertension, atrial fibrillation, heart failure, chronic kidney disease, coronary heart disease, stroke/TIA, and pre-diabetes.
Who is responsible for monitoring?
You, as an independent prescriber, are responsible for determining the safety and suitability of prescribed medications.
What types of monitoring are there?
Types include blood monitoring (haematology, biochemistry, drug monitoring) and physical monitoring (respiratory, cardiac tests, foot checks, etc.).
What does haematology monitoring include?
Includes RBCs, haemoglobin, MCV, WBC, platelets, ESR, CRP, INR, and APTT.
What do raised ALT levels indicate?
Raised ALT levels indicate cellular damage in liver function tests.
What should be done if TSH is <0.2 in a patient on levothyroxine?
Reduce the dose by 25mcg and recheck in 6-8 weeks.
What do high urea levels indicate?
High urea levels indicate renal failure, dehydration, high protein intake, hypercatabolic states, or hemorrhage.
What drugs commonly cause low sodium?
PPIs
SSRIs
What is hyponatraemia and its danger signs?
Hyponatraemia is defined as sodium levels less than 135.
Think PPI, diuretics, SSRIs. Symptoms include muscle cramps, slurred speech, confusion, etc.
What is hypoglycaemia and its danger signs?
Hypoglycaemia is defined as blood glucose levels less than 4.
Think hypoglycaemics (Gliclazide, insulin, SGLT2i). Symptoms include nausea, sweating, weakness or fainting, confusion, headache, cold sweat, bizarre behaviour, etc.
What is anaemia and its danger signs?
Anaemia is indicated by low ferritin and abnormal FBC.
Think NSAIDs, anti-platelets, DOACs. Symptoms include tiredness, palpitations, shortness of breath, dizziness, etc.
What is hyperkalaemia and its danger signs?
Hyperkalaemia is defined as potassium levels greater than 5.5.
Think ACEI/ARB/MRA. Symptoms include palpitations, shortness of breath, nausea and vomiting, chest pain.
What is hypokalaemia and its danger signs?
Hypokalaemia is defined as potassium levels less than 3.5.
Think diuretics, theophylline. Symptoms include muscle weakness, intestinal atony, increased sensitivity to digoxin, polyuria, polydipsia, etc.
