Citation

Al Jawder S, AlJishi E, Al-Otaibi S, Al-Shahrani MS. Open Access Emerg. Med. 2018; 10: 31-36.

Copyright

(Copyright © 2018, Dove Press)

DOI

10.2147/OAEM.S151095

PMID

unavailable

Abstract

A 51-year-old woman, who intentionally ingested a massive dose of −60 g of valproic acid which she was using as a mood stabilizer for bipolar affective disorder, presented within 30 minutes of ingestion to the emergency department. The patient was asymptomatic and was immediately started on decontamination therapy with activated charcoal (AC). Drug serum levels, liver functions, and ammonia levels were tested and followed up during treatment. Due to the massive ingestion and continuous rise in serum drug levels, the patient received regular multiple doses of AC, as well as l-carnitine for liver protection. The patient was started on extracorporeal therapy in the form of renal replacement therapy in the intensive care unit (ICU), followed by intermittent hemodialysis. Drug serum levels dropped significantly. Ammonia levels showed improvement with treatment. The patient was discharged from the ICU after 14 days of treatment. She was stable and in good condition with no residual hepatic or central nervous system (CNS) manifestations. © 2018 Al Jawder et al.

Language: en

Keywords

adult; human; female; survival; case report; bipolar disorder; Hemodialysis; hemodialysis; suicide attempt; disease severity; Valproic acid; drug overdose; clinical article; physical examination; middle aged; intensive care unit; activated carbon; drug blood level; valproic acid; ammonia; renal replacement therapy; Article; treatment duration; carnitine; vital sign; liver function; loading drug dose; ammonia blood level; liver protection; asymptomatic disease; L-carnitine; Multiple dose activated charcoal