Sodium valproate

Redenbaugh, J. E.; Sato, Shuzo; Penry, J. Kiffin; Dreifuss, Fritz E.; Kupferberg, Harvey J.

doi:10.1212/wnl.30.1.1

Cited by 58 publications

(15 citation statements)

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“…Single out-patient levels as were done in this study serve little, if any, useful purpose as a guide to therapy or compliance unless the latter is gross, as it was in one of our cases. Drug half lives in children are much shorter than adults and hourly variations greater, particularly for carbamazepine and valproate, when it may be considerable (Livingstone et al, 1979;Redenbaugh et al, 1980). Although most of our patients took their drugs about the same time in the morning and blood samples were taken between 14.30 h and 16.30 h, individual variation in rates of metabolism is such that meaningful conclusions cannot be drawn on their AEDL.…”

Section: Discussionmentioning

confidence: 94%

Drug compliance and seizure control in epileptic children

Lisk

Greene

1985

Postgraduate Medical Journal

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Summary The drug taking habits and compliance of 16 epileptic children were studied by means of a questionnaire, ‘pill’ count and serum antiepileptic drug levels (AEDL). The questionnaire method overestimated patients' compliance while, because of the pharmacokinetics of antiepileptic drugs in children, single outpatients' drug levels may be misleading thereby not always reflecting the true degree of compliance. Ten patients (62%) took more than 85% of their medication. Above this level of compliance there was a positive relationship to seizure control. It would appear that drug compliance in epileptic children is as unsatisfactory as it is in adults on whom they largely depend for the administration of their medication.

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Section: Discussionmentioning

confidence: 94%

Drug compliance and seizure control in epileptic children

Lisk

Greene

1985

Postgraduate Medical Journal

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“…Drowsiness is more common in patients on multiple-drug therapy with phenobarbital, as valproate increases the plasma concentration of phenobarbital through inhibition of its metabolism (Kapetanovic et al, 1980). Drowsiness and mild ataxia were experienced with fasting plasma valproate concentrations of as low as 21.8-56.5 pdml (Redenbaugh et al, 1980). Similar or higher plasma concentrations of valproate were found in patients who were not drowsy.…”

Section: Overview Of Common Adverse Effectsmentioning

confidence: 85%

Adverse Effects of Valproate

Schmidt

1984

Epilepsia

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Any review on adverse effects alone without due reference to the therapeutic benefits of a valuable drug is in danger of exaggerating the side effects. Nevertheless, it is reasonable to expect that some of the signs and symptoms seen in patients with epilepsy may not be due to the epilepsy but rather to the adverse effects of antiepileptic drugs (Schmidt and Seldon, 1982). Awareness of the common and the less well‐known adverse effects will increase the safety of a drug, such as valproate, that is taken chronically by many patients worldwide. From a clinical perspective, any unwanted reaction may be seen as an adverse effect. Adverse effects can usually be classified in a small number of rather rare but sometimes fatal and mostly unpredictable drug‐induced diseases or in more frequent, mostly mild, dose‐related, and reversible side effects (Schmidt, 1983). The adverse effects of valproate are difficult to classify in that scheme, because dose dependency is rare and the mechanisms of most adverse reactions are not well understood. It may therefore be useful to start with an overview of the common adverse effects observed in therapeutic trials, followed by a review of the individual organ systems involved in the adverse effects of valproate, including rather rare drug‐induced diseases. The purpose of this review is to provide an overview of the adverse effects of valproate, except for its hepatotoxic and teratogenic actions, which will be covered by Prof. Jeavons (S50–55).

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“…The decreases in CL were generally small in magnitude. 1977;Perucca et at.. 1978a, b;Redenbaugh et al. The CL of valproic acid is restrictive (Klotz and Antonin, 1977) and in this situation the free concentration is a major determinant of clearance rate.…”

Section: Discussionmentioning

confidence: 98%

First-Dose and Steady-State Pharmacokinetics of Valproic Acid in Children with Seizures

Hall

Otten

Irvine-Meek

et al. 1983

Clinical Pharmacokinetics

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The serum concentration-time curve of valproic acid was followed in 25 children after single oral doses of the drug and at steady-state. Total body clearance (CL), half-life (t 1/2), and apparent volume of distribution (Vd) were calculated from the terminal portion of the curve and from the area under the serum concentration-time curve (AUC). The CL and Vd were significantly greater at steady-state (0.42 +/- 0.20 ml/min/kg and 0.231 +/- 0.067 L/kg, respectively) than after a single dose (0.32 +/- 0.13 ml/min/kg and 0.191 +/- 0.055 L/kg, respectively). This difference was most pronounced in patients with valproic acid dosage increases in excess of 20% and no change in their concurrent anticonvulsant therapy between the single-dose and steady-state study periods. The t 1/2 was not significantly different between the 2 study periods. There was a significant correlation between age and both CL and Vd after single doses and at steady-state. The t 1/2 did not appear to be age related. These results suggest that the adequacy of the dosage regimen must be determined during maintenance therapy rather than extrapolated from data obtained after a single dose. Re-evaluation of therapy as the child grows older may also be necessary in view of the age-related differences in valproic acid pharmacokinetics which this study has demonstrated.

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Sodium valproate

Cited by 58 publications

References 0 publications

Drug compliance and seizure control in epileptic children

Drug compliance and seizure control in epileptic children

Adverse Effects of Valproate

First-Dose and Steady-State Pharmacokinetics of Valproic Acid in Children with Seizures

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