10-08-2006, 01:56 PM
A 32 yo pt with grand mal seizure receives 1200mg of Carbamazepine maintenance therapy daily and has serum level of 8mcg/ml. Aftet 2 months the pt relapses. pts current carbamazepine serum level is 4mcg/ml. Pts mother is ensuring the compliance and she and the pt is telling you that he has not missed one single dose in last two onths. What is the reason of this drop in serum carbamazepine level and what would be the next step?
A, Pt is not taking his medication. Admit the pt in the hospital.
B, Pt is not taking his medication, change the antiepileptic to phenytoin.
C, Pt might be taking some street drug,do a urine drug screen.
D, This is a classic case of auto-induction, increase the dose of carbamezapine.
A, Pt is not taking his medication. Admit the pt in the hospital.
B, Pt is not taking his medication, change the antiepileptic to phenytoin.
C, Pt might be taking some street drug,do a urine drug screen.
D, This is a classic case of auto-induction, increase the dose of carbamezapine.