A patient with a history of seizures has been admitted to the hospital for a minor infection and will be going home tomorrow
The patient has been taking lamotrigine (Lamictal) and valproic acid (Depakote). Upon assessment, the nurse notes that the patient has widespread lesions of the skin and mucous membranes and a temperature of 102.9°F, and that the patient complains of malaise. The nurse should suspect
a. a hematological reaction.
b. Stevens-Johnson syndrome.
c. toxic levels of valproic acid (Depakote).
d. toxic epidermal necrolysis.
ANS: B
Lamotrigine can cause life-threatening rashes, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Concurrent use of valproic acid increases the risk.
No evidence indicates a hematological reaction.
No evidence indicates Depakote toxicity, which may manifest as hepatotoxicity and pancreatitis.
Symptoms of toxic epidermal necrolysis are not manifested in this patient.
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