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Zorluk: KolayMonitoring and Treatment Evaluation

A psychiatrist is evaluating a 31-year-old male patient who recently experienced a severe acute manic episode. The physician decides to initiate pharmacotherapy with valproate as a mood stabilizer. Before starting this medication and periodically during the initial months of treatment, specific laboratory parameters must be monitored due to the drug's known adverse effect profile. Which of the following diagnostic studies should be routinely obtained for this patient? (Select all that apply)

  1. Complete blood countCevap
  2. Hepatic function panelCevap
  3. C
    Thyroid-stimulating hormone
  4. D
    Serum creatinine
  5. E
    Fasting lipid panel

Cevap

Complete blood count AND Hepatic function panel
Valproate is associated with two major, potentially severe adverse effects that require routine serologic monitoring: hepatotoxicity and dose-related hematologic abnormalities (most commonly thrombocytopenia). A baseline hepatic function panel is essential because valproate carries a black box warning for fatal hepatic failure. Similarly, a baseline complete blood count is necessary to establish a baseline platelet count and monitor for subsequent bone marrow suppression during dose titrations.

Adım Adım Çözüm

1
Identify the initiated medication and its class.
The medication is valproate, an antiepileptic drug commonly used as a mood stabilizer for bipolar disorder.
Understanding the specific drug is required to recall its unique adverse effect profile and safety guidelines.
2
Recall the major adverse effects associated with the identified medication.
Major toxicities of valproate include hepatotoxicity, thrombocytopenia, and neural tube defects (in pregnant patients).
Routine monitoring requirements are directly derived from the drug's most serious or common side effects.
3
Select the laboratory tests that screen for these specific adverse effects.
A hepatic function panel screens for hepatotoxicity, and a complete blood count screens for thrombocytopenia.
Baseline and ongoing evaluation of these serologic parameters ensures patient safety during pharmacotherapy.

Anahtar Kavram

Baseline and ongoing monitoring for valproate therapy requires a complete blood count (to assess for thrombocytopenia) and a hepatic function panel (to assess for hepatotoxicity).
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Konular

Monitoring and Treatment Evaluation

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