another pharmacology question

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Posted by luther from IP on July 26, 2015 at 13:44:10:

Your patient is a 35 year old epileptic who takes phenytoin 300 mg daily and primidone 500mg every eight hours daily.He visits you in the clinic complaining of a recent(past1-2 days)increase in seizure frequency.He claims
to be very compliant with his medicine and states that he took his last dose 1.5 hours prior to his visit.Following chart review you request stat drug primidone=0(5-12),phenytoin=5mcg/ml(10-
20),phenobarbitone=12mcg/ml(15-40).Statements which could explain the drug levels observed include:

(a) an unusually high degree of hepatic microsomal enzyme induction
(b) compliance is strongly suspect he has taken no medicine for the past 2 days
(c) the patient did take both of his seizure medications 1.5 hours before his clinic visit,however he probably did not take any for 3-4days before that time
(d) the patient may have been compliant with phenytoin recently(past 1-2 days)but not with his primidone

4.D only
5.all of the above

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