prathapdoctor
Forum Elite
Topics: 12
Posts: 406
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A 19-yr old man comes to physician because of frequent nose bleeds over the past 3 wks,He has bipolar disorder currently well controlled with lithium bicarobnate,bupropion and valproic acid.physical examination shows no abnormalities except for dried blood in the nares, Mental status examination shows an anxious and slight motor restlessness, serum studies show a lithium conc of carbonate of 1.3 meq per ltr,[therapeutic range =0.6 to 1.2] and valproic acid level of 77 micro gr per ml[ therapeutic range 40-100] which of the following is the most appropriate next step in management.
A. Measurement of serum AST activity.
B.Measurement of serum bupropion level.
C.Platelet count.
D.Discontinuation of lithium carbonate therapy.
E. Discontinuation of valproic acid therapy.
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| saadtazjam
Forum Elite
Topics: 9
Posts: 160
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D?
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| nida
Forum Elite
Topics: 23
Posts: 87
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I would choose C) Platelet count.
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| Guptashutosh
Forum Elite
Topics: 35
Posts: 354
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Valproate causes thrombocytopenia , option E discontinue valproic acid
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| ndspider
Forum Senior
Topics: 5
Posts: 69
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C First before DC meds!
First check the platelet count before you stop Valporic Acid.
Besides, suddenly stopping Valpo isn't someting you should do in someone who has bipolar.
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| anjushree
Forum Guru
Topics: 64
Posts: 386
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hepatotoxicity caused by valproic acid
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| anjushree
Forum Guru
Topics: 64
Posts: 386
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valproic acid interfere with plt function----bleeding
ans---E
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| Data297
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prathapdoctor please post the answer and explination I think it's C
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| prod
Forum Junior
Topics: 9
Posts: 53
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C 
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