Smoking Cessation in a Patient with Epilepsy
Write a prescription for nicotine dependence and have every line marked: drug choice, dose, route, frequency and duration, checked against the patient's allergies, current medicines, renal function and the interaction database, with each error explained.
easy8 scoring rules
- Patient
- 45 years, female, 70 kg
- Diagnosis
- Nicotine dependence
- Renal function
- eGFR 95 mL/min/1.73m²
- Allergies
- None known
- Current medicines
- lamotrigine 200 mg twice daily
The scenario
A 45-year-old woman attends the pre-operative assessment clinic before elective cholecystectomy. She has well-controlled epilepsy and takes lamotrigine 200 mg twice daily. She smokes 20 cigarettes per day and has done for 20 years. Her first cigarette of the day is within 30 minutes of waking. She is keen to stop smoking before surgery to reduce her operative risk. She has no drug allergies and takes no other regular medicines. She is not pregnant. Examination is unremarkable; blood pressure 128/78 mmHg, pulse 72 bpm, BMI 27 kg/m². Baseline investigations: creatinine 0.8 mg/dL, eGFR 95 mL/min/1.73m², ALT 22 IU/L. She has heard that varenicline and bupropion are effective for smoking cessation but is worried about her epilepsy. Write a prescription for a smoking cessation treatment, stating the drug, formulation, dose and directions.
Your task
The patient was referred from the surgical clinic. She is motivated to quit. She has no previous attempts with pharmacotherapy.
What gets marked
- Whether you chose an indicated drug, and whether you avoided the contraindicated ones.
- Dose, route, frequency and duration against the range for this patient.
- Renal and hepatic dose adjustment where this patient's numbers demand it.
- Allergy cross-reactivity and interactions with the medicines already on the chart.
- The instructions and monitoring you write, not only the drug you pick.
8 scoring rules apply to this scenario. A single critical error fails the attempt whatever the score.
Log in to prescribe for "Smoking Cessation in a Patient with Epilepsy"
A free account opens the prescription pad: search the formulary, write the chart, and have it marked line by line by the safety engine.
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.