ABLE III Final Monitoring Parameters

Albuterol Monitoring Parameters

Efficacy Monitoring Parameters. Resolution of asthma symptoms and PFTs.

Toxicity Monitoring Parameters. Use alternative therapy or seek emergency treatment if paradoxical bronchospasm occurs.

Amlodipine 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 peripheral edema, increased HR, LFTs.

Atenolol 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.

Atorvastatin Monitoring Parameters

Efficacy Monitoring Parameters. Total cholesterol, LDL-cholesterol, and triglycerides levels; HDL-cholesterol levels.

Toxicity Monitoring Parameters.Signs/symptoms of rhabdomyolysis (myalgias, dark urine, fatigue) or hepatotoxicity; LFTs should be performed at baseline and as clinically necessary; serum creatine kinase should be measured in patients experiencing muscle pain and in those receiving other drugs associated with myopathy.

Amiodarone Monitoring Parameters

Efficacy Monitoring Parameters. ECG for normalized sinus rhythm. HR and symptomatic improvement if used for rate control.

Toxicity Monitoring Parameters. ECG for QTc prolongation; eye examinations at baseline and every 6 mo; chest x-ray and pulmonary function tests every 3-6 mo; liver enzymes; thyroid function tests

Apixaban Monitoring Parameters

Efficacy Monitoring Parameters. Absence of thrombosis if used for prophylaxis. Absence of stroke if used for atrial fibrillation. Resolution of DVT or PE if used for treatment.

Toxicity Monitoring Parameters. Hepatic and renal function. Assess for signs of bleeding

Azelastine Monitoring Parameters

Efficacy Monitoring Parameters. Decrease in rhinitis symptoms.

Toxicity Monitoring Parameters. Seek medical attention if severe allergic reactions occur.

Benazepril 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 dry cough, hypotension; monitor baseline and periodic electrolytes (particularly if combined with other medications that affect serum potassium), SCr, BUN, urine protein.

Bisoprolol Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP.

Toxicity Monitoring Parameters.Signs/symptoms of heart failure, decreased heart rate, ECG. Baseline and periodic serum and urine electrolytes; renal function; uric acid, and FBG.

Budesonide Monitoring Parameters

Efficacy Monitoring Parameters. Monitor PFTs. Resolution of asthma symptoms (symptoms, number of exacerbations, nighttime awakenings, need for rescue albuterol).

Toxicity Monitoring Parameters. Growth velocity in pediatric patients during prolonged therapy.

Budesonide/Formoterol Monitoring Parameters

Efficacy Monitoring Parameters. Monitor PFTs. Resolution of asthma symptoms (symptoms, number of exacerbations, nighttime awakenings, need for rescue albuterol).

Toxicity Monitoring Parameters. Growth velocity in pediatric patients during prolonged therapy; use alternative therapy or seek emergency treatment if paradoxical bronchospasms occur.

Candesartan Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, resolution of heart failure; may require 3-6 wk to obtain therapeutic response.

Toxicity Monitoring Parameters. Report signs/symptoms of hypotension, tachycardia. Baseline and periodic sodium, potassium, total bicarbonate, BUN, SCr, and urinalysis prior to initiating therapy.

Carvedilol Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP and HR, 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, bronchospasm, increased or decreased blood glucose levels in diabetic patients, and hepatotoxicity.

Cetirizine Monitoring Parameters

Efficacy Monitoring Parameters. Improvement in rhinitis or urticaria symptoms.

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

Chlorthalidone Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, swelling, edema, urine output.

Toxicity Monitoring Parameters. Signs/symptoms of heart failure, decreased HR. Monitor serum electrolytes (particularly sodium), uric acid, and renal and hepatic function at baseline and periodically.

Clonidine Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP or improvement of mental and behavioral symptoms of ADHD.

Toxicity Monitoring Parameters. Rebound HTN, increased HR, palpitations, syncope.

Clopidogrel Monitoring Parameters

Efficacy Monitoring Parameters. Prevention of thrombotic events.

Toxicity Monitoring Parameters.Signs/symptoms of bleeding, especially with concomitant anticoagulant therapy.

Colesevelam 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 GI side effects, vitamin A, D, E, or K deficiencies.

Dabigatran Monitoring Parameters

Efficacy Monitoring Parameters. Prevention of clotting or recurrence of clotting. The aPTT assay can be used as a qualitative indicator of anticoagulation status.

Toxicity Monitoring Parameters. Monitor for signs and symptoms of bleeding; evaluate renal function.

Digoxin Monitoring Parameters

Efficacy Monitoring Parameters. ECG, decreased HR, improvement in signs/symptoms of heart failure; therapeutic serum range 0.8-2 ng/mL for atrial fibrillation and <1.0 ng/mL for heart failure. Serum concentrations should be obtained after 3-5 d of therapy. Levels should optimally be drawn 12-24 h after the last dose, but at a minimum 6-8 h after the last dose.

Toxicity Monitoring Parameters. ECG for cardiac dysrhythmia, excessive bradycardia; SCr, and serum electrolytes (especially potassium, magnesium, calcium).

Diltiazem Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, reduction in chest pain, decreased number of angina attacks, reduction in use of nitroglycerin for chest pain.

Toxicity Monitoring Parameters.Signs/symptoms of heart failure, low HR, signs/symptoms of liver toxicity; exacerbations of angina pectoris or acute coronary insufficiency while tapering chronic therapy, especially in patients with CAD.

Dipyridamole Monitoring Parameters

Efficacy Monitoring Parameters. Prevention of AMI, stroke, other thrombotic complications.

Toxicity Monitoring Parameters.Signs/symptoms of dizziness, GI distress.

Doxazosin Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, improvement in urinary symptoms.

Toxicity Monitoring Parameters. Signs of hypotension, increased HR (reflex tachycardia).

Edoxaban Monitoring Parameters

Efficacy Monitoring Parameters. Absence of thrombosis if used for prophylaxis. Resolution of DVT or PE if used for treatment.

Toxicity Monitoring Parameters. Hepatic and renal function. Assess for signs of bleeding.

Enalapril Monitoring Parameters

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

Toxicity Monitoring Parameters. Signs 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.

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.

Nebivolol Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP and HR.

Toxicity Monitoring Parameters. Decreased HR, bronchospasm, blood glucose levels in diabetic patients.

Niacin Monitoring Parameters

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

Toxicity Monitoring Parameters. Signs/symptoms of rhabdomyolysis (myalgias, dark urine, arthralgias, fatigue), yellowing of eyes or skin, severe abdominal pain, monitor LFT, CBC; serum creatine kinase if muscle pain occurs, FBG or HbA_1c, uric acid.

Nifedipine Monitoring Parameters

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

Toxicity Monitoring Parameters. Signs/symptoms of peripheral edema, angina, tachycardia, heart failure.

Nitroglycerin Monitoring Parameters

Efficacy Monitoring Parameters. Decreased use of sublingual nitroglycerin to treat anginal episodes, reduction in angina episodes, reduction in anginal pain.

Toxicity Monitoring Parameters. Signs/symptoms of hypotension, problematic headaches, or decreasing efficacy (drug tolerance). BP and HR.

Olmesartan Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP.

Toxicity Monitoring Parameters. Report signs/symptoms of hypotension. Baseline and periodic potassium, SCr, prior to initiating therapy and periodically thereafter.

Omega-3-Ethyl Esters Monitoring Parameters

Efficacy Monitoring Parameters. Reduction in triglyceride levels.

Toxicity Monitoring Parameters. LDL, LFTs.

Prasugrel Monitoring Parameters

Efficacy Monitoring Parameters. Stent patency and prevention of clotting.

Toxicity Monitoring Parameters. Monitor for signs and symptoms of bleeding. Consider periodic hematocrit/hemoglobin, as well as platelet function testing.

Pravastatin Monitoring Parameters

Efficacy Monitoring Parameters. Baseline fasting lipid panel (total cholesterol, LDL, HDL, and triglycerides), repeat 4-12 wk after initiation or dose adjustment.

Toxicity Monitoring Parameters. Signs/symptoms of rhabdomyolysis (myalgias, dark urine, arthralgias, fatigue) or hepatotoxicity; LFTs at baseline and if concern for hepatotoxicity; check serum creatine kinase in patients experiencing myopathy.

Propranolol Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, chest pain, number of angina attacks, nitroglycerin use, signs/symptoms of CHF, reduction in tremors, frequency of migraines.

Toxicity Monitoring Parameters. Signs/symptoms of CHF, decreased HR, bronchospasm, increased FPG, exacerbations of angina pectoris, or acute coronary insufficiency. Monitor HR and BP.

Quinapril Monitoring Parameters

Efficacy Monitoring Parameters. BP, signs/symptoms of heart failure.

Toxicity Monitoring Parameters. Signs/symptoms of angioedema, persistent dry cough, hypotension; monitor baseline and periodic electrolytes, SCr, BUN, urine protein.

Ramipril Monitoring Parameters

Efficacy Monitoring Parameters. BP, progression of heart failure.

Toxicity Monitoring Parameters. Angioedema (swelling of the face, eyes, lips, tongue, or throat), persistent dry cough, hypotension; baseline and periodic potassium, SCr, BUN, and urine protein.

Ranolazine Monitoring Parameters

Efficacy Monitoring Parameters. Improvement in angina symptoms, improved exercise tolerance.

Toxicity Monitoring Parameters. Baseline and follow-up ECG to evaluate QTc if concerns for prolongation; monitor BP and renal function at baseline and periodically.

Rivaroxaban Monitoring Parameters

Efficacy Monitoring Parameters. Prevention of clotting or recurrence of clotting. Routine monitoring of anticoagulation tests is not necessary with rivaroxaban. If used, anti–Xa activity is the preferred test.

Toxicity Monitoring Parameters. Signs and symptoms of bleeding, renal function for potential dose adjustment, CBC, vital signs.

Rosuvastatin Monitoring Parameters

Efficacy Monitoring Parameters. Total cholesterol, LDL-cholesterol, and triglycerides levels; HDL-cholesterol levels.

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

Sacubitril/Valsartan Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, signs/symptoms of heart failure.

Toxicity Monitoring Parameters. Signs/symptoms of hypotension, tachycardia, angioedema (swelling of the face, eyes, lips, tongue, or throat), hyperkalemia (confusion, body weakness, uneven heartbeat, or numbness/tingling in hands or feet), reduction in urination, jaundice, or skin rash. Monitor vital signs, weight, LFTs.

Simvastatin Monitoring Parameters

Efficacy Monitoring Parameters. Reduction in total cholesterol, LDL-cholesterol, and triglycerides levels; increase in HDL-cholesterol levels. Obtain baseline lipid panel, fasting lipid panel 4-12 wk after initiation of therapy and every 3-12 mo thereafter.

Toxicity Monitoring Parameters. Obtain baseline LFTs, SCr, and BUN. Repeat LFTs if signs of hepatotoxicity (fatigue, abdominal pain, yellowing of skin, or sclera). Consider CPK in patients with symptoms of myopathy (pain cramping, weakness).

Spironolactone Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, reduction in edema, weight.

Toxicity Monitoring Parameters. Monitor SCr, potassium levels, ECG if symptoms of hyperkalemia occur.

Terazosin Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, improvement in obstructive urinary symptoms.

Toxicity Monitoring Parameters. Sign/symptoms of hypotension, increased HR, LFTs.

Ticagrelor Monitoring Parameters

Efficacy Monitoring Parameters. Prevention of thrombotic events.

Toxicity Monitoring Parameters. Signs/symptoms of bleeding, especially with concomitant anticoagulant therapy.

Tiotropium Monitoring Parameters

Efficacy Monitoring Parameters. Monitor pulmonary function tests, shortness of breath.

Toxicity Monitoring Parameters. Seek medical attention if severe anticholinergic side effects occur, including bladder obstruction, narrow-angle glaucoma, prostatic hyperplasia, and urinary retention or difficulty.

Tolvaptan Monitoring Parameters

Efficacy Monitoring Parameters. If using for hyponatremia, monitor serum sodium levels carefully; normalization of serum sodium. If using for autosomal dominant polycystic kidney disease, monitor SCr.

Toxicity Monitoring Parameters. Monitor for dehydration, serum electrolytes, neurologic status, signs and symptoms of syndrome of inappropriate antidiuretic hormone secretion. Monitor LFTs and discontinue if increased.

Torsemide Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, 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, uric acid, and blood glucose at baseline and every 3-6 mo after therapy.

Triamterene/Hydrochlorothiazide Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, reductions in edema.

Toxicity Monitoring Parameters. Altered serum and urine electrolytes (calcium, magnesium, potassium, sodium), decreased renal function (increased SCr or decreased urine output), 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.

Varenicline Monitoring Parameters

Efficacy Monitoring Parameters. Abstinence from tobacco.

Toxicity Monitoring Parameters. Mental status changes.

Valsartan Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, signs/symptoms of heart failure, decreased proteinuria

Toxicity Monitoring Parameters. Signs/symptoms of hypotension, tachycardia, angioedema (swelling of the face, eyes, lips, tongue, or throat), hyperkalemia (confusion, body weakness, uneven heartbeat, or numbness/tingling in hands or feet), reduction in urination, jaundice, or skin rash. Monitor vital signs, weight, LFTs.

Verapamil Monitoring Parameters

Efficacy Monitoring Parameters. Decreased BP, improvement in HR and rhythm, reduction in chest pain, decreased number of weekly angina attacks, reduction in use of nitroglycerin for chest pain.

Toxicity Monitoring Parameters. Signs/symptoms of heart failure, decreased HR, signs/symptoms of liver toxicity. Exacerbations of angina pectoris or acute coronary insufficiency; while tapering chronic therapy, especially in patients with ischemic heart disease. Monitor LFTs, ECG, and vital signs.

Warfarin Monitoring Parameters

Efficacy Monitoring Parameters. Measure initial INR after the first 2-3 doses and subsequently at intervals no longer than every 4 wk, once stable dose has been achieved; may monitor every 12 wk in stable patients, use clinical judgment; patients at high risk of bleeding require more frequent monitoring. INR target and therapeutic range depend on indication. Atrial fibrillation/atrial flutter: target 2.5 (range 2-3); prosthetic heart valves: target 2.5 (range 2-3); mechanical mitral or aortic valve: target 3 (range 2.5-3.5); AMI, ST-segment elevation: target 3 (range 2.5-3.5, with aspirin); venous thromboembolism, prophylaxis and treatment (including PE, DVT, hip/knee arthroplasty): target 2.5 (range 2-3).

Toxicity Monitoring Parameters. Signs/symptoms of bleeding, CBC, LFT, stool guaiac test.