A patient has begun taking phenobarbital after experiencing several seizures and is currently receiving 60 mg PO twice daily. After two weeks of therapy, the patient has a serum drug level of 30 mcg/mL and reports feeling drowsy much of the day
What will the nurse tell this patient? a. "I will contact your provider to discuss changing your dosing to once daily to mi-nimize the drowsiness."
b. "The drug level is low and you may need a higher dose, but taking it three times daily will reduce the drowsiness."
c. "This side effect is expected and should decrease over time. You should avoid driving in the meantime."
d. "Your lab work shows a higher than nor-mal level of the drug and your provider will probably lower your dose."
A
Phenobarbital has a long half-life and may be given once daily at bedtime to help manage its sedative effects. The serum drug level is within the normal range of 15 to 40 mcg/mL, so the dose does not need to be adjusted. Increasing the dose and the frequency is not necessary since the drug levels are therapeutic and scheduling the drug to three times daily will compound the sedative effects. The sedative side effects do not increase over time.
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