Flashcards in Therapeutic Drug Monitoring Deck (8)
What is meant by first order kinetics?
Rate of elimination is proportional to the amount of drug
What is meant by zero order kinetics?
Rate of elimination is independent of the amount of the drug (ethanol, phenytoin, salicyclates)
Give examples of drugs with a wide therapeutic index
NSAIDs, benzodiazepines, antibiotics, beta blockers
Give examples of drugs with a narrow therapeutic index
Anti-epileptics (phenytoin, sodium valproate), lithium, strong antibiotics (gentamycin, amikacin, vancomycin), digoxin, immunosuppressives (ciclosporin, tacrolimus)
What drug levels are commonly monitored during their use?
Digoxin, aminophylline, phenytoin, carbazmazepine, lithium, gentamycin, amikacin, vancomycin, ciclosporin
What are digoxin levels affected by?
Renal impairment, amiodarone and hypokalaemia
When should you check genatmycin levels?
o If they are taking once daily – check level dose after 3 doses
o If they have renal impairment – check their trough level
o For multiple daily dosing (as in infective endocarditis) – do a peak level after the 3rd dose and a trough level before the next dose