A patient is admitted to the hospital for a new onset seizure disorder, and the prescriber orders carbamazepine (Tegretol)
The nurse reviewing the patient's medical history notes that the patient is taking warfarin. The nurse will contact the provider to discuss _____ dose.
a. reducing the carbamazepine
b. reducing the warfarin
c. increasing the carbamazepine
d. increasing the warfarin
ANS: D
Carbamazepine induces hepatic drug-metabolizing enzymes and can increase the rate at which it and other drugs are metabolized, including oral contraceptives and warfarin; therefore, patients taking any of these drugs would need an increased dose. Reducing the dose of either drug is not indicated. Increasing the dose of carbamazepine may be necessary but only after serum drug levels have been checked.
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