Question

You receive a lab report that your patient's carbamazepine (Tegretol) level is 14mg/L. The desired therapeutic range for this drug is 4-12mg/L, and toxic effects may begin at 15mg/L. What is your reaction?

a) Increase the dosage to bring it within the therapeutic range
b) Monitor the patient closely for signs of toxicity
c) Reduce the dosage to maintain it within the therapeutic range
d) All of the above.

Answer 1

The correct response when carbamazepine levels are slightly above the therapeutic range but below the toxicity level is to reduce the dosage or maintain it while closely monitoring the patient for signs of toxicity.

Step-by-step explanation:

If a patient's carbamazepine level is 14mg/L, which is slightly above the therapeutic range of 4-12mg/L, but below the toxicity level of 15mg/L, the appropriate response would be to monitor the patient closely for signs of toxicity while keeping the dosage the same or reducing it to maintain it within the therapeutic range. Increasing the dosage would be incorrect, as the levels are already higher than desired. Thus, the correct answer in this scenario would be to reduce the dosage to maintain it within the therapeutic range (option c), as it is important to avoid the onset of toxic effects associated with excessive carbamazepine levels.