A patient has been on carbamazepine (Tegretol) therapy for 3 weeks and comes to the clinic for a follow-up appointment
The patient complains of fatigue, headache, and vertigo. After laboratory tests are completed, which laboratory value would cause the most concern?
a. Hemoglobin: 12 g/dL
b. Leukocytes: 8,000 mm3
c. Platelets: 280,000 mm3
d. Carbamazepine (Tegretol): 10 mcg/mL
ANS: A
The hematologic effects of carbamazepine can cause leukopenia, anemia, and thrombocytopenia. With the patient's complaints of fatigue, the nurse should focus on the hemoglobin levels, which are low (14 to 18 g/dL) and may indicate anemia.
The leukocytes values are within normal limits (5,000 to 10,000mm3).
The platelets levels are within normal limits (150,000 to 350,000 mm3).
A normal carbamazepine level is 10 to 20 mcg/mL.
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