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Review Case Reports
Treatment of valproic acid overdose with meropenem in an epileptic patient: A case report and literature review.
- David Cunningham, Kacie Clark, and Kito Lord.
- Department of Pharmacy, Regional One Health, 877 Jefferson Ave, Memphis, TN 38103, United States. Electronic address: dcunningham@regionalonehealth.org.
- Am J Emerg Med. 2022 Mar 1; 53: 284.e1-284.e3.
AbstractValproic acid (VPA) and derivatives are effective anticonvulsants that are also used for numerous mood disorders. VPA toxicity can cause central nervous system (CNS) depression, dose related hyperammonemia, and eventually hepatotoxicity. While traditional treatment of VPA toxicity often includes l-carnitine, activated charcoal, and hemodialysis; an interaction with carbapenem class antibiotics has been well established in literature and may offer a different avenue of treatment. This case describes a 38 year-old female with a past medical history of epilepsy effectively treated with meropenem to rapidly and safely lower toxic VPA levels after an acute ingestion. A review of four VPA poisoning case reports and the interaction with carbapenem class antibiotics is also included.Copyright © 2021 Elsevier Inc. All rights reserved.
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