Acute Valproate Poisoning
In: Journal of Clinical Psychopharmacology, Jg. 25 (2005-08-01), Heft 4, S. 376-380
Online
serialPeriodical
Zugriff:
The clinical features, complications, and pharmacokinetics of intentional acute valproic acid (VPA) overdoses are described. Alteration in fatty acid metabolism is evaluated and therapy-induced changes are discussed. Central nervous system features were the predominant clinical manifestations (6/6), followed by respiratory failure (5/6) and multiorgan failure (2/6). Mechanical ventilation was required in 5 of 6 patients because of respiratory depression or deep coma. Hemodialysis was applied in 4/6 of the cases due to hyperammonemia, worsening neurologic condition, or organ dysfunction. Cerebral edema and hemorrhagic pancreatitis ensued in 2/6 of the patients and ICU mortality was 2/6. VPA peak levels ranged from 520 to 1700 mg/L with a mean of 1127 mg/L. Ammonia was elevated in all cases with a mean of 550 μg/dL. All patients showed signs of impaired mitochondrial β-oxidation with increase of medium- and long-chain acylcarnitines in serum. Severe VPA overdose is associated with a high mortality rate requiring early medical interventions. Beside supportive intensive care, hemodialysis can be considered as an adjunctive measure.
Titel: |
Acute Valproate Poisoning
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Autor/in / Beteiligte Person: | Eyer, Florian ; Felgenhauer, Norbert ; Gempel, Klaus ; Steimer, Werner ; Gerbitz, Klaus-Dieter ; Zilker, Thomas |
Link: | |
Zeitschrift: | Journal of Clinical Psychopharmacology, Jg. 25 (2005-08-01), Heft 4, S. 376-380 |
Veröffentlichung: | 2005 |
Medientyp: | serialPeriodical |
ISSN: | 0271-0749 (print) ; 1533-712X (print) |
DOI: | 10.1097/01.jcp.0000168485.76397.5c |
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