Dose monitor

Biomarkers for internal close of the intoxicant—dose monitoring. Bioniarkers for early biological changes following exposure— effect... 

Hirsh J, Warkentin TE, Shaughnessy SG et al (2001) Heparin and low-molecular-weight heparin mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety. Chest 119(Suppl.) 64S-94S... 

Dosages in older adults are usually in the lower range. Because older adults are more susceptible to cardiovascular and neuromuscular reactions to the antipsychotic drugs the nurse must dosely monitor them. It is important to increase the dosages gradually. 

Drug Initial Daily Dose Target or Maximum Daily Dose Monitoring... 

Recommend treatment (including drug selection, dosing, monitoring, and alternative treatments) for group B Streptococcus based on guidelines of the Centers for Disease Control and Prevention. 

Hyperlipidemia Diet HMG-CoA reductase inhibitors (stati ns) Gemfibrozil Ezetemibe CSA greater than TAC consider switch to TAC discontinue or hold SRL CSA/TAC may increase statin levels start at lowest dose Monitor for muscle cramps, CPK levels and LFTs Adjust dose in those with Rl Caution with concomitant statin Often used in combination with a statin... 

Pathogen (Adult Doses Pediatric Doses) Monitoring Duration (Days)... 

Hepatic Nicotinic acid hepatotoxicity (including cholestatic jaundice) has occurred. Cases of severe hepatic toxicity, including fulminant hepatic necrosis, have occurred in patients who have substituted sustained-release nicotinic acid products for immediate-release nicotinic acid at equivalent doses. Monitor ALT prior to treatment, every 6 to 12 weeks during the first year, and periodically thereafter (approximately 6-month intervals). 

Administer 500 mg to 1 g daily in divided doses monitored by blood levels. The usual initial dosage is 250 mg twice daily at 12-hour intervals for the first 2 weeks. Do not exceed 1 g/day. 

Uses Serious Infxns d/t susceptible bacteria Action Bactericidal X cell wall synth Dose Adults. 250-1000 mg (imipenem) IV q6-8h, 500-750 mg IM 1/2 h Peds. 60-100 mg/kg/24 h IV q6h -1- if CrCl is <70 mL/min Caution [C, +/-] Probenecid T tox Contra Ped pts w/ CNS Infxn (t Sz risk) <30 kg w/ renal impair Disp Inj SE Szs if drug accumulates, GI upset, thromboc5rtopenia Interactions T Risks of Szs W/ cyclosporine, ganciclovir T effects W/ probenecid EMS Monitor for S/Sxs of sup Infxn T Sz risk w/ high doses monitor for signs of electrolyte disturbances and hypovolemia d/t D OD May cause N/V/D symptomatic and supportive... 

Serum lithium concentrations drawn immediately prior to next dose (8-12 hr after previous dose), monitor biweekly until stable then q2-3mo therapeutic range 1.0-1.5 mEq/L (acute), 0.6-1.2 mEq/L (maintenance)... 

Drug dependence or tolerance may occur with prolonged use of high doses Monitoring Parameters... 

Universal concomitant nephrotoxicity with cyclosporine-A. Requires close dose monitoring. Hydration with sodium chloride prior to dosing may help prevent renal toxicity. Renal toxicity is usually reversible. 

Galantamine (Razadyne) [Cholinesterase Inhibitor] Uses Alzheimer Dz Action Acetylcholinesterase inhibitor Dose 4 mg PO bid, T to 8 mg bid after 4 wk may T to 12 mg bid in 4 wk Caution [B, ] T Effect w/ suc-cinylcholine, amiodarone, dildazem, verapamil, NSAIDs, digoxin X- effect w/ anticholinergics, T risk of death vs placebo Contra Severe renal/hepadc impair Disp Tabs, soln SE GI disturbances, wt loss, sleep disturbances, dizziness, HA Interactions T Effects W/ amitriptyline, cimeddine, erythromycin, fluoxetine, fluvoxamine, ketoconazole, paroxetine, quinidine EMS Use succinylcholine w/ caudon, may need a reduced dose monitor ECG for induced conduction abnormalities OD May cause cholinergic Sxs (SLUDGE), muscle weakness, resp depression, and Szs atropine may be used as antidote... 

Some simple definitions of dosing, monitoring, and control are given below, although with the advent of real-time systems, the distinctions between monitoring and control are becoming distinctly blurred. 

Blethen S. Dosing, monitoring, and safety in adults with growth hormone deficiency. Endocrinologist 1998 16 994-9. 

Tornqvist, M., and H.H. Landin. 1995. Hemoglobin adducts for in vivo dose monitoring and cancer risk estimation. J. Occup. Environ. Med. 37(9) 1077-1085. 

Because variability exists in dosing, monitor serum concentration. 

VORICONAZOLE RIFABUTIN t plasma concentrations of rifabutin, with risk of toxic effects of rifabutin (nausea, vomiting). Dangerous toxic effects such as leukopenia and thrombocytopenia may occur Due to inhibition of metabolism of rifabutin by the CYP3A4 isoenzymes by voriconazole Avoid concomitant use. If absolutely necessary, dose monitoring of FBC, liver enzymes and examination of eyes for uveitis and corneal opacities are necessaiy... 

Inform physicians if either drug is introduced. Avoid sudden changes of the herb dose. Monitor PR and blood pressure closely if either drug is introduced. Discontinue the herb if side-effects worsen. 

Patients who do not wish to or cannot compiy with biood testing and dose monitoring... 

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