ABLE III Quiz 1 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.