Citation

Ge Y, Xu B, Zhu S, Li C, He Q, Zhu T, Fan R, Gong D. Basic Clin. Pharmacol. Toxicol. 2017; 121(4): 368-370.

Copyright

(Copyright © 2017, Nordic Pharmacological Society, Publisher John Wiley and Sons)

DOI

10.1111/bcpt.12807

PMID

28481454

Abstract

Valproic acid (VPA) is widely used for the treatment of epilepsy. However, its overdose can cause intoxication and could be life-threatening. Due to the lack of specific antidote and poorness of endogenous clearance, extracorporeal treatment for severe intoxication cases is indicated. Here, we report a case of severe intoxication of VPA which was successfully treated with liver support therapy. A previously healthy woman was admitted due to coma and hypotension after intentional ingestion of 20 g of sodium valproate. Her serum concentration of VPA measured on admission was 420.84 mg/L. In addition to standard therapy, she received two sessions of extracorporeal blood purification using a system based on fractionated plasma separation and adsorption mode integrated with continuous veno-venous haemofiltration (FPSA-CVVH), which is usually used for liver support therapy at our hospital. Her serum concentration of VPA decreased dramatically to 40.18 mg/L and her consciousness recovered completely within 24 hr after admission. Therefore, although haemodialysis has been reported to be effective in the treatment for VPA poisoning, FPSA-CVVH may provide an option for patients who require bedside therapy but have an unstable haemodynamic status or other conditions that result in inability to endure haemodialysis.

Language: en

Keywords

Humans; Adult; Female; Severity of Illness Index; Drug Overdose; Treatment Outcome; Suicide, Attempted; Anticonvulsants; Hemofiltration; Hypotension; Coma; Valproic Acid