High dose antipsychotic monitoring form Test No 1 No 2 No 3 No 4 No 5 No 6 ECG (QTc) (before Date treatment, within first week, every 1 to 3 months during Result early stages, then annually) Urea & Electrolytes ( if ok) Date (before treatment, at 1 month, at 3 months, and Result when indicated) Date BP (before treatment and as clinically indicated) Result Temperature (before Date treatment and as clinically Result indicated) Date (before treatment and as clinically indicated) Result Full blood count (before Date treatment and as clinically Result indicated) LFTs (before treatment, at 1 Date month, at 3 months, and Result when indicated) Abnormal results Please provide details – Test / result Date Comment Action
High dose antipsychotic monitoring form Test No 1 No 2 No 3 No 4 No 5 No 6 ECG (QTc) (before treatment, within first week, every 1 to 3 months during early stages, then annually) Date Result Urea & Electrolytes ( if ok) (before treatment, at 1 month, at 3 months, and when indicated) Date Result BP (before treatment and as clinically indicated) Date Result Temperature (before treatment and as clinically indicated) Date Result (before treatment and as clinically indicated) Date Result Full blood count (before treatment and as clinically indicated) Date Result LFTs (before treatment, at 1 month, at 3 months, and when indicated) Date Result Abnormal results – Please provide details Test / result Date Comment Action
mp18z-appendix-2-high-dose-antipsychotic-therapy-hdat-monitoring-form.docx