Which laboratory test would be expected to monitor potential hepatic injury for anticonvulsant therapy?

• A. Liver enzymes
• B. Electrolyte panel
• C. Thyroid function tests
• D. Renal function tests

Answer: (A)

Monitoring for potential liver injury from anticonvulsant therapy hinges on checking liver enzymes because damage to liver cells releases these enzymes into the bloodstream. Elevations in AST and ALT signal hepatocellular injury, making them the best early indicators of hepatotoxicity. Baseline testing before starting therapy and periodic rechecking during treatment are standard, especially with drugs known for higher hepatotoxic risk (like valproic acid or carbamazepine). A broader set of liver tests (including alkaline phosphatase and bilirubin) can provide more detail, but transaminases are the most liver-specific early warning signs.

Electrolyte panels assess fluid and electrolyte balance, not liver injury. Thyroid function tests evaluate thyroid hormones, and renal function tests assess kidney performance. None are primary tools for detecting hepatotoxicity.