Monitoring Requirements Consultant responsibility GP responsibility Every Sample Clauses

Monitoring Requirements Consultant responsibility GP responsibility Every. 6 months • Assess compliance, ask patient about adverse effects (breathlessness, non-productive cough) and review possible interactions • TFTs (and for up to 12 months after discontinuation), U&Es, LFTs Annually • History & examination, Heart rate & ECG Other monitoring if applicable • Digoxin level- assess serum digoxin levels if dose increased or toxicity is suspected • INR- more frequent monitoring of INR both during and after amiodarone treatment (initially weekly for first 7 weeks) • Chest X-ray or CT scan if clinically indicated (suspected pulmonary toxicity) • Eye exam- Assess if new or worsening visual symptoms occur. • Check for drug interactions if new agents added to patient’s usual prescription Baseline *Loading History & examination ♦ adverse effects ♦ ♦ Heart rate & 12 lead ECG ♦ ♦ TFTs ♦ U&Es ♦ LFTs ♦ ♦ Digoxin level (if applicable) ♦ ♦ INR (if applicable) ♦ ♦ CXR ♦ PFTs inc DLCO ♦ Actions to be taken Parameter Action Symptoms of pulmonary toxicity (new/worsened cough or shortness of breath) Perform prompt ECG and CXR to exclude alternative diagnoses. If pulmonary toxicity remains a possibility, contact cardiologist/specialist or a respiratory physician urgently for confirmation of diagnosis and consideration of alternative anti-arrhythmics. Acute admission may be required. Early investigation with HRCT chest scan is important. ECG If there are signs of the following discuss with the oncall cardiology specialist: • QTc interval ≥ 500 milliseconds • QRS duration>120 milliseconds • prolonged PR interval (>240 milliseconds) if previously normal • Morbitz Type II or complete heart block GPs can also contact cardiologist for advice on • Interpretation of ECG • Consideration for stopping treatment e.g. if patient develop permanent AF/ ventricular tachycardia. Thyroid function tests (see appendix 1) An increase of up to 40% above the baseline T4 is a normal effect of amiodarone. This occurs approximately 2 months after initiation and does not require discontinuation if there is no clinical or further biological evidence (TSH) of thyroid disease. If TFTs are borderline repeat test in 6 weeks. In the event of thyrotoxosis seek the urgent advice of an endocrinologist. Liver function tests (See appendix 2) Normal results - continue treatment and reassess in 6 months If ALT increase within three times the normal range and patient is not jaundiced, continue amiodarone and repeat LFTs in 2 weeks. If still raised, refer to initiating hospital specialist ur...
View SourceView Similar (3)

Related to Monitoring Requirements Consultant responsibility GP responsibility Every

  • Management Responsibility No Limited Partner, as such, shall take part in the management of the business or transact any business for the Partnership.

  • Engineer Responsibilities No subcontract relieves the Engineer of any responsibilities under this contract.

  • Monitoring Responsibilities The Custodian shall furnish annually to the Fund, during the month of June, information concerning the foreign sub-custodians employed by the Custodian. Such information shall be similar in kind and scope to that furnished to the Fund in connection with the initial approval of this Contract. In addition, the Custodian will promptly inform the Fund in the event that the Custodian learns of a material adverse change in the financial condition of a foreign sub-custodian or any material loss of the assets of the Fund or in the case of any foreign sub-custodian not the subject of an exemptive order from the Securities and Exchange Commission is notified by such foreign sub-custodian that there appears to be a substantial likelihood that its shareholders' equity will decline below $200 million (U.S. dollars or the equivalent thereof) or that its shareholders' equity has declined below $200 million (in each case computed in accordance with generally accepted U.S. accounting principles).

  • Repair Responsibility Cracks exceeding 1/4 inch in width or 1/4 inch in vertical displacement will be repaired by patching or other remedies.

  • Management Responsibilities The exclusive representative recognizes the right and obligation of the School Board to efficiently manage and conduct the operation of the School District within its legal limitations and with its primary obligation to provide educational opportunity for the students of the School District.