ABLE III Quiz 2 Monitoring Parameters

Enoxaparin Monitoring Parameters

Efficacy Monitoring Parameters. Prevention or resolution of thrombosis, depending on indication.

Toxicity Monitoring Parameters. Signs and symptoms of bleeding, CBC, LFTs. Patients with renal failure, obese patients, pregnant patients, and others at risk of bleeding complications should be monitored using anti–factor Xa testing.

Ezetimibe Monitoring Parameters

Efficacy Monitoring Parameters. Reduction in total cholesterol, LDL-cholesterol, and triglycerides levels; increase in HDL-cholesterol levels.

Toxicity Monitoring Parameters. Signs/symptoms of rhabdomyolysis (myalgias, dark urine, arthralgias, fatigue), yellowing of eyes or skin, severe abdominal pain, LFT and CBC, SCr.

Felodipine Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, reduction in chest pain, decreased number of weekly angina attacks, reduction in use of prophylactic nitroglycerin to relieve chest pain.

Toxicity Monitoring Parameters. Signs/symptoms of peripheral edema, increased HR (reflex tachycardia), signs/symptoms of liver damage.

Fenofibrate Monitoring Parameters

Efficacy Monitoring Parameters. Reduction in total cholesterol, LDL-cholesterol, and triglycerides levels; increase in HDL-cholesterol levels.

Toxicity Monitoring Parameters. Signs/symptoms of rhabdomyolysis (myalgias, dark urine, arthralgias, fatigue), yellowing of eyes or skin, severe abdominal pain; monitor LFT, CBC at baseline, 12 wk after initiation of therapy, or dose increases; serum creatine kinase should be measured in patients experiencing muscle pain and in those receiving other drugs associated with myopathy.

Fexofenadine Monitoring Parameters

Efficacy Monitoring Parameters. Improvement in rhinitis or urticaria symptoms.

Toxicity Monitoring Parameters. Seek medical attention for signs of severe CNS toxicity.

Fluticasone Nasal Monitoring Parameters

Efficacy Monitoring Parameters. Control of rhinitis signs and symptoms.

Toxicity Monitoring Parameters. While only small amounts of fluticasone reach systemic circulation, BMD and growth and development in children should be monitored. Routine ophthalmologic examinations should be performed. Monitor for signs and symptoms of adrenal suppression or infection.

Fluticasone Oral Monitoring Parameters

Efficacy Monitoring Parameters. Control of asthma, as measured by PFTs, frequency of asthma exacerbations, and need for rescue inhaler use.

Toxicity Monitoring Parameters. While only small amounts of fluticasone reach systemic circulation, BMD and growth and development in children should be monitored. Routine ophthalmologic examinations should be performed. Monitor for signs and symptoms of adrenal suppression or infection (including oral candidiasis).

Fluticasone/Salmeterol Monitoring Parameters

Efficacy Monitoring Parameters. Control of asthma or COPD symptoms, as measured by PFTs, frequency of asthma or COPD exacerbations or need for rescue inhaler use.

Toxicity Monitoring Parameters. While only small amounts of fluticasone and almost no salmeterol reach systemic circulation, BMD and growth and development in children should be monitored. Routine ophthalmologic examinations should be performed. Monitor for signs and symptoms of adrenal suppression or infection (including oral candidiasis), glaucoma and cataracts, serum potassium (hypokalemic patients), glucose (diabetic patients).

Fosinopril Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, decrease in signs of heart failure.

Toxicity Monitoring Parameters. Signs/symptoms of angioedema (swelling of the face, eyes, lips, tongue, or throat), severe persistent dry cough, hypotension; monitor baseline and periodic electrolytes, SCr, BUN, urine protein.

Furosemide Monitoring Parameters

Efficacy Monitoring Parameters. Increased urine output, reduction in edema, daily weights. For treating renal failure, increase in urine volume, CrCl, BUN, and electrolytes.

Toxicity Monitoring Parameters. Severe volume depletion can occur. Monitor serum and urine electrolytes (particularly sodium), uric acid, and blood glucose at baseline and every 3-6 mo after therapy. Audiometric test (if ototoxicity suspected).

Gemfibrozil Monitoring Parameters

Efficacy Monitoring Parameters. Primary, reduction in triglyceride levels. Secondary, reduction in total cholesterol, LDL-cholesterol, increase in HDL-cholesterol levels. Monitor baseline and every 6 mo.

Toxicity Monitoring Parameters. Seek medical attention if signs/symptoms of rhabdomyolysis (myalgias, dark urine, arthralgias, fatigue), yellowing of eyes or skin, and severe abdominal pain. LFTs and complete blood counts should be performed at baseline, 12 wk after initiation of therapy or dose increases. Serum creatine kinase should be measured in patients experiencing muscle pain and in those receiving other drugs associated with myopathy.

Hydralazine Monitoring Parameters

Efficacy Monitoring Parameters. Decrease in systolic and diastolic BP, improvement in signs/symptoms of heart failure.

Toxicity Monitoring Parameters. Signs/symptoms of hypotension or liver damage. CBC and antinuclear antibody titers at baseline and periodically during prolonged treatment.

Hydrochlorothiazide Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, reductions in edema.

Toxicity Monitoring Parameters. Decreased serum and urine electrolytes (particularly serum sodium), decreased renal function, increased serum uric acid or blood glucose. Seek medical attention if skin rash, yellowing of eyes or skin, decreased urine output, or symptoms of gout occur. Dizziness, lightheadedness may occur. Monitor sodium, potassium, BUN, creatinine, skin to assess for photosensitivity, skin cancer.

Hydroxyzine Monitoring Parameters

Efficacy Monitoring Parameters. Improvement in symptoms for which administered (anxiety, pruritus, insomnia).

Toxicity Monitoring Parameters. Seek medical attention for signs of severe CNS toxicity.

Ipratropium/Albuterol Monitoring Parameters

Efficacy Monitoring Parameters. Resolution of COPD symptoms, improved PFTs.

Toxicity Monitoring Parameters. Use alternative therapy or seek emergency treatment if paradoxical bronchospasms occur. Monitor BP, HR, signs of CNS stimulation, serum glucose, serum potassium, signs/symptoms of glaucoma, urinary retention, shortness of breath.

Irbesartan Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP. Monitor BP weekly; may require 2-4 wk for full effect.

Toxicity Monitoring Parameters. Report signs/symptoms of hypotension, tachycardia. Baseline and periodic electrolyte panel, renal function tests, and urine protein are recommended.

Isosorbide Mononitrate Monitoring Parameters

Efficacy Monitoring Parameters. Decreased use of sublingual nitroglycerin, reduction in angina episodes.

Toxicity Monitoring Parameters. Report signs/symptoms of hypotension, problematic headaches, or decreasing efficacy (drug tolerance) to prescriber.

Labetalol Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP and HR.

Toxicity Monitoring Parameters. Signs/symptoms of peripheral edema, increased HR, signs/symptoms of liver damage.

Levalbuterol Monitoring Parameters

Efficacy Monitoring Parameters. Resolution of asthma symptoms and improvement in PFTs.

Toxicity Monitoring Parameters. BP, HR, PFTs, serum potassium.

Levocetirizine Monitoring Parameters

Efficacy Monitoring Parameters. Improvement in rhinitis or urticaria symptoms.

Toxicity Monitoring Parameters. Seek medical attention for signs of severe CNS toxicity; monitor SCr.

Lisinopril Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP.

Toxicity Monitoring Parameters. Signs/symptoms of angioedema (swelling of the face, eyes, lips, tongue, or throat), severe persistent cough, hypotension; monitor baseline and periodic electrolytes, SCr, BUN, and urine protein.

Losartan Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP.

Toxicity Monitoring Parameters. Signs/symptoms of peripheral edema. Baseline and periodic electrolyte panel, renal function tests, and urine protein are recommended.

Lovastatin Monitoring Parameters

Efficacy Monitoring Parameters. Reduction in total cholesterol, LDL-cholesterol, and triglyceride levels; increase in HDL-cholesterol levels. Assess at baseline and periodically during treatment.

Toxicity Monitoring Parameters. Signs/symptoms of rhabdomyolysis (myalgias, dark urine, arthralgias, fatigue) or hepatotoxicity. LFTs, blood glucose, and HbA_1c should be performed at baseline, 6-12 wk after initiation of therapy, and periodically thereafter. Serum creatine kinase should be measured in patients experiencing muscle pain and in those receiving other drugs associated with myopathy.

Metoprolol Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, reduction in chest pain, decreased number of weekly angina attacks, reduction in use of prophylactic nitroglycerin to relieve chest pain, improvement in signs/symptoms of heart failure.

Toxicity Monitoring Parameters. Signs/symptoms of heart failure, decreased HR. Monitor serum electrolytes and renal function at baseline and periodically.

Mometasone Monitoring Parameters

Efficacy Monitoring Parameters. Control of rhinitis signs and symptoms.

Toxicity Monitoring Parameters. While only small amounts of mometasone reach systemic circulation, BMD and growth and development in children should be monitored. Routine ophthalmologic examinations should be performed. Monitor for signs and symptoms of adrenal suppression or infection.

Montelukast Monitoring Parameters

Efficacy Monitoring Parameters. Resolution of clinical signs of asthma (improved PFTs, decreased rescue inhaler use, etc) or symptoms of rhinitis.

Toxicity Monitoring Parameters. Seek medical attention if change in behavior/mood, including suicidal thinking or neuropsychiatric symptoms (eg, agitation, aggression, anxiousness, etc) occurs.