Display options
Cite
Al Jawder S, AlJishi E, Al-Otaibi S, et al. All guns blazing: management and survival of massive valproic acid overdose - case report and literature review. Open Access Emerg Med. 2018;10:31-36doi: 10.2147/OAEM.S151095.
Al Jawder, S., AlJishi, E., Al-Otaibi, S., & Al-Shahrani, M. S. (2018). All guns blazing: management and survival of massive valproic acid overdose - case report and literature review. Open access emergency medicine : OAEM, 1031-36. https://doi.org/10.2147/OAEM.S151095
Al Jawder, Shaikha, et al. "All guns blazing: management and survival of massive valproic acid overdose - case report and literature review." Open access emergency medicine : OAEM vol. 10 (2018): 31-36. doi: https://doi.org/10.2147/OAEM.S151095
Al Jawder S, AlJishi E, Al-Otaibi S, Al-Shahrani MS. All guns blazing: management and survival of massive valproic acid overdose - case report and literature review. Open Access Emerg Med. 2018 Jan 25;10:31-36. doi: 10.2147/OAEM.S151095. eCollection 2018. PMID: 29416381; PMCID: PMC5790066.
Copy Download .nbib Format: NLM
Share it on

Open Access Emerg Med. 2018 Jan 25;10:31-36. doi: 10.2147/OAEM.S151095. eCollection 2018.

All guns blazing: management and survival of massive valproic acid overdose - case report and literature review.

Open access emergency medicine : OAEM

Shaikha Al Jawder, Eiman AlJishi, Shaikhah Al-Otaibi, Mohammed S Al-Shahrani

Affiliations

  1. King Hamad University Hospital, Busaiteen, Bahrain.
  2. Emergency Medicine Department.
  3. Emergency and Critical Care Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

PMID: 29416381 PMCID: PMC5790066 DOI: 10.2147/OAEM.S151095

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.

Keywords: hemodialysis; l-carnitine; multiple dose activated charcoal; valproic acid

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

References

  1. Ann Emerg Med. 2002 Jun;39(6):616-21 - PubMed
  2. J Toxicol Clin Toxicol. 2000;38(7):755-60 - PubMed
  3. Clin Toxicol (Phila). 2008 Aug;46(7):661-76 - PubMed
  4. Eur J Clin Pharmacol. 1983;24(2):243-6 - PubMed
  5. Acta Neurol Scand. 2008 Nov;118(5):281-90 - PubMed
  6. J Clin Psychopharmacol. 2004 Oct;24(5):521-6 - PubMed
  7. Encephale. 2001 Jul-Aug;27(4):365-72 - PubMed
  8. Clin Toxicol (Phila). 2015 Jun;53(5):454-65 - PubMed
  9. Arh Hig Rada Toksikol. 2008 Dec;59(4):295-8 - PubMed
  10. Indian J Crit Care Med. 2011 Apr;15(2):120-2 - PubMed
  11. Hepatology. 1982 Sep-Oct;2(5):648-9 - PubMed
  12. Crit Care Med. 2009 Dec;37(12):3161-4 - PubMed

Publication Types