A woman is treated for a seizure disorder with levetiracetam.She began experiencing dizziness and fatigue.Blood cell values indicated decreased RBC count and low hematocrit.Trough blood concentration of levetiracetam was assessed to be 15 µg/mL,although her dosing should have resulted in a trough therapeutic concentration of 3 µg/mL.She claimed that she was not taking antacids or any other medication.What is the likely cause of the elevated levetiracetam?

Question

Quizplus · Accepted Answer

The symptoms of dizziness and fatigue, along with the decreased red blood cell count and hematocrit, suggest anemia, which can be caused by impaired kidney function. Levetiracetam is primarily eliminated by the kidneys, so impaired renal function could cause the drug to accumulate in the body, leading to elevated concentrations. This may be why the patient's trough therapeutic concentration was much higher than expected. Option A is incorrect as levetiracetam does not metabolize into gabapentin. Option C is incorrect as there is no documented interaction between levetiracetam and phenytoin that would result in increased concentration. Option D is incorrect as gabapentin is not involved in this case.

A Woman Is Treated for a Seizure Disorder with Levetiracetam