On-call scenario 5: Introduction
"Hi. It's one of the medical doctors. I’ve got a patient who is nil-by-mouth, so they can’t take their usual tablets. I want to switch their carbamazepine tablets to suppositories instead, but need some advice on dosing please?"
You ask for further details and establish the following...
Caller: Max Walker, FY2 , Neurology ward, ext. 3765.
Patient: Christine Smith, hospital no. 1166791, age 70 years.
Medicines: Carbamazepine modified-release tablets 400mg BD (Tegretol brand) and pramipexole 88 micrograms ON. No allergies.
Clinical problem: Patient admitted to hospital following an ischaemic stroke. They have severe dysphagia and are therefore nil-by-mouth (NBM). The indication for carbamazepine is epilepsy, and the patient's seizures currently well controlled.
Where do you think you might look to answer this question?