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Drug level monitoring in palliative patients
  1. Joanne Bartlett and
  2. Elizabeth Freshwater
  1. Medical, John Taylor Hospice, Birmingham, UK
  1. Correspondence to Dr Elizabeth Freshwater, Medical, John Taylor Hospice, Birmingham B24 0DF, UK; elizabeth.freshwater{at}


Palliative medicine is always patient centred and promotes the principle that no unnecessary investigations are performed. The case is reported of a patient with suspected carbamazepine toxicity presenting as progression of symptoms of primary brain tumour. A comparison is made of the symptoms and signs of toxicity versus tumour, and an aid for deciding when to perform therapeutic drug level monitoring for some common drugs.

  • brain
  • clinical decisions
  • hospice care
  • pharmacology

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  • Collaborators James Kendrick; Nikhil Sanyal.

  • Contributors Both authors named made substantial contributions to the design of the work, including the acquisition, analysis or interpretation of data. They both drafted the work and revised it critically for important intellectual content. They both gave final approval of the version published. They both agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.