Question

scenario: a patient on carbamazepine for bipolar disorder develops symptoms of dizziness and diplopia. question: what should be the next step? - increase the dose of carbamazepine. - check carbamazepine serum levels. - discontinue carbamazepine. - add a second mood stabilizer.

Explanation:

Dizziness and diplopia can be signs of carbamazepine toxicity or sub - therapeutic/toxic serum levels. Increasing the dose (first option) could worsen symptoms. Discontinuing the drug (third option) is too hasty without knowing the serum levels. Adding a second mood stabilizer (fourth option) is not appropriate without assessing the current drug's levels. Checking the serum levels (second option) is the logical next step to determine if the levels are within the therapeutic range or toxic, which will guide further management.

Answer:

B. Check carbamazepine serum levels.