Besides liver enzymes, which laboratory test should be monitored to assess hematologic effects during valproic acid therapy?

• A. Complete blood count
• B. Liver enzymes
• C. Urinalysis
• D. Creatinine clearance

Answer: (A)

Hematologic safety with valproic acid hinges on detecting effects on the blood cells, including anemia, leukopenia, and especially thrombocytopenia. A complete blood count directly measures red cells, white cells, and platelets, so it can reveal decreases in any of these components and flag bleeding risk if platelets are low. While liver enzymes monitor liver injury, and urinalysis or creatinine clearance assess kidney-related issues, none specifically track blood cell status. Thus, the complete blood count is the most appropriate test to monitor hematologic effects during valproic acid therapy.