Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
1. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
2. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
3. Dwayne was not originally prescribed the correct amount of carbamazepine.
4. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Question 2
Carbamazepine has a Black Box Warning due to life-threatening:
1. Renal toxicity, leading to renal failure
2. Hepatotoxicity, leading to liver failure
3. Dermatologic reaction, including Steven's Johnson and toxic epidermal necrolysis
4. Cardiac effects, including supraventricular tachycardia
The patient interview often requires note taking.
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Drugs for Seizures
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Summary of SOAP Note Content Cont.