Regularly check intraocular pressure (IOP) using tonometry. Target IOP reduction should be determined in consultation with the ophthalmologist, but generally aim for a clinically meaningful decrease.
Monitor for common side effects, including paresthesias, particularly in the extremities. Patients should report any tingling, numbness, or altered sensation. Assess for metabolic acidosis through blood gas analysis, especially if high doses are used or if the patient has pre-existing renal or respiratory issues.
Observe patients for signs of dehydration, including decreased urine output, dry mouth, and dizziness. Encourage adequate fluid intake. Watch for electrolyte imbalances, specifically hypokalemia and hyponatremia. Regular blood tests can detect these.
Kidney function should be assessed through serum creatinine and blood urea nitrogen (BUN) levels, especially in patients with pre-existing renal impairment. Adjust dosage accordingly based on renal function. Liver function tests (LFTs) may also be beneficial, particularly if the patient presents with any symptoms suggestive of liver damage.
Encourage patients to report any visual disturbances, including blurred vision or changes in color perception. These warrant further ophthalmological evaluation. Document all findings thoroughly, including IOP measurements, side effect reports, and laboratory results.
Consider periodic complete blood counts (CBCs) to monitor for potential bone marrow suppression, a rare but serious side effect. This is particularly important in patients with a history of bone marrow disorders or those receiving concurrent medications that affect bone marrow.
