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Monitoring Drugs
Exam 1
22
Pharmacology
Graduate
02/17/2012

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Cards

Term
Lithium Monitoring
Definition

*Renal fcn (BUN/Cr)-baseline then q2-3mo x 6mo, then q6-12mo

*Preg test at baseline

*Thyroid fcn-baseline then 1-2times x 6mo, then q6-12mo once dose is stabilized

*ECG if >40y/o-baseline

Term
2nd gen antipsychotics monitoring
Definition

*wt checks/BMI calc-baseline then q1mo x 3mo, then q3mo

*FLP/FBG/HgbA1c-baseline, at 3mo, then qyr

Term
Clozapine
Definition
*WBC qwk x6mo then q2wks x6mo, then qwk indefinitely
Term
Stimulants monitoring
Definition

*BP and pulse

*Sx's of depression, aggression or hostility

*Growth rate in kids

*signs of CNS stimulation

*Routine ECG's and ECHO if pre-existing heart dz

Term
Atomoxetine monitoring
Definition

*BP and pulse

*Pt growth

*Attn, hyperactivity and anxiety

*Worsening of aggressive behavior or hostility

Term
CBZ monitoring
Definition

*CBC with diff

*Lipid panel

*CMP (Na, BUN/Cr, LFTs)

*Ca2+ and Vit D (>6mo tx)->DEXA

*UA

*TFTs

*Preg test

Term
Oxcarbazepine monitoring
Definition
*Serum Na esp in the first 3mo of therapy
Term
Phenytoin monitoring
Definition

*VS if given IV b/c Fosphey is a Class IB anti-arrhythmic

*CBC

*LFTs

*Ca2+ and Vit D (>6mo tx)->monitor DEXA

Term
Lacosamide monitoring
Definition
*ECG at baseline in pts with conduction problems or severe cardiac dz
Term
Zonisamide monitoring
Definition

*BUN/Cr

*Serum [HCO3]-baseline then q2-4mo

Term
Ethosuximide monitoring
Definition

*CBC

*LFTs

Term
Phenobarb monitoring
Definition

*CBC

*LFTs

*Ca2+ and Vit D (>6mo tx)->DEXA

Term
Tiagabine monitoring
Definition

*CBC

*CMP

Term
Valproate monitoring
Definition

*LFTs

*CBC

*Serum ammonia

Term
Topiramate monitoring
Definition

*BMP (lytes, BUN/Cr)

*Serum [HCO3]-baseline then q2-4mo

Term
Felbamate monitoring
Definition

*CBC-baseline then q1-2mo

*LFTs-baseline then q1-2mo

Term
Levetiracetam monitoring
Definition
*Psych effects (suicidal thoughts and depression)
Term
Metformin monitoring
Definition

*H&H and RBC indices-baseline then qyr

*Vit B12-q2-3yrs

*SCr-baseline then qyr

Term
Bisphosphonate monitoring
Definition

*Reeval in 1mo to assess tolerance

*consider measurements of bone-turnover markers at 3 and 6mo

*BMD with DEXA-at 1yr then twice a yr

Term
Levothyroxine monitoring
Definition

*TSH-after 6-8wks

*TFTs-after 4-6wks fo tx (when euthyroid do it q6-12mo)

*If central hypothyroidism then monitor [FT4]

Term
Thionamides monitoring
Definition

*Some clinical resolution of thyrotoxicosis w/in 2wks

*TSH and FT4-q4-6wks until stabilized

Term
Management of Thyroid dz in pregnancy
Definition

*monitor TSH q4wks during the 1st half of preg

*Then, once at 26-32wks

(Want TSH <2.5 in 1st trimester;<3.0 in the 2nd and 3rd)

*Post-partum: resume pre-preg dose and check TSH in 6wks

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