A 32-year-old Caucasian man comes to the office for a routine follow-up visit. He was diagnosed with epilepsy three years ago, and has been taking carbamazepine 800 mg/day ever since. He does not use tobacco, alcohol or illicit drugs. His family history is not significant. Physical examination shows no abnormalities. The patient is concerned about the potential side effects of his medication. Which of the following complications is this patient at greatest risk for?

Question

A 32-year-old Caucasian man comes to the office for a routine follow-up visit.  He was diagnosed with epilepsy three years ago, and has been taking carbamazepine 800 mg/day ever since.  He does not use tobacco, alcohol or illicit drugs.  His family history is not significant.  Physical examination shows no abnormalities.  The patient is concerned about the potential side effects of his medication.  Which of the following complications is this patient at greatest risk for?

Quizplus · Accepted Answer

Explanation: Carbamazepine can cause bone marrow suppression. Patients should be made aware of early symptoms such as fever, mouth ulcers, easy bruising or petechiae, which can be markers of the development of neutropenia, aplastic anemia or thrombocytopenia. (Choice A) There is a risk of thrombocytopenia, not thrombosis. (Choice B) Pulmonary fibrosis or interstitial lung disease has not been associated with the use of this drug. (Choice D) Urinary complications include renal failure or urinary retention, not the development of kidney stones. (Choice E) Carbamazepine use has been associated with hyponatremia and SIADH, not hypernatremia. Educational objective: Although the frequency is not clear, neutropenia and bone marrow suppression due to carbamazepine use are significant adverse reactions. Elderly patients are also at risk of SIADH. Because of some mild anticholinergic effects, there is a risk of glaucoma, urinary retention or constipation.

A 32-Year-Old Caucasian Man Comes to the Office for a Routine