Hyperammonemia Associated with Valproic Acid Concentrations

نویسندگان

  • Marta Vázquez
  • Pietro Fagiolino
  • Cecilia Maldonado
  • Ismael Olmos
  • Manuel Ibarra
  • Silvana Alvariza
  • Natalia Guevara
  • Laura Magallanes
  • Ivette Olano
چکیده

Valproic acid, a branched short-chain fatty acid, has numerous action mechanisms which turn it into a broad spectrum anticonvulsant drug and make its use possible in some other pathologies such as bipolar disorder. It is extensively metabolized in liver, representing β -oxidation in the mitochondria one of its main metabolic route (40%). Carnitine is responsible for its entry into the mitochondria as any other fatty acid. Long-term high-dose VPA therapy or acute VPA overdose induces carnitine depletion, resulting in high levels of ammonia in blood. As a high correlation between salivary valproic acid levels and plasma ultrafiltrate levels was found in humans, saliva becomes a promising monitoring fluid in order to study valproic acid pharmacokinetics and its toxic effect. Extended-release (twice daily) formulations of valproic acid or carnitine supplementation are the proposed two therapeutic strategies in order to reverse hyperammonemia.

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Altered Mental Status and Hyperammonemia after Overdose of Valproic Acid with Therapeutic Valproic Acid Concentrations

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عنوان ژورنال:

دوره 2014  شماره 

صفحات  -

تاریخ انتشار 2014