A 60-year-old man on ICU develops new-onset seizures. He has been on CRRT for 5 days. His anti-epileptic medication (levetiracetam) level returns as s...

Question

A 60-year-old man on ICU develops new-onset seizures. He has been on CRRT for 5 days. His anti-epileptic medication (levetiracetam) level returns as subtherapeutic. What is the most likely reason for the low levetiracetam level?

Accepted Answer

CRRT removes levetiracetam efficiently due to its low protein binding (~10%) and small molecular weight, requiring supplemental dosing

Answer

Hepatic enzyme induction from concomitant medications

Answer

Levetiracetam is not absorbed enterally

Answer

Laboratory error

Answer

Levetiracetam is not effective in ICU patients

uk-fficm MCQ (SBA): AED Dosing in CRRT

A 60-year-old man on ICU develops new-onset seizures. He has been on CRRT for 5 days. His anti-epileptic medication (levetiracetam) level returns as subtherapeutic. What is the most likely reason for the low levetiracetam level?