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

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 decontam...

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Autores principales: Al Jawder, Shaikha, AlJishi, Eiman, Al-Otaibi, Shaikhah, Al-Shahrani, Mohammed S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790066/
https://www.ncbi.nlm.nih.gov/pubmed/29416381
http://dx.doi.org/10.2147/OAEM.S151095
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author Al Jawder, Shaikha
AlJishi, Eiman
Al-Otaibi, Shaikhah
Al-Shahrani, Mohammed S
author_facet Al Jawder, Shaikha
AlJishi, Eiman
Al-Otaibi, Shaikhah
Al-Shahrani, Mohammed S
author_sort Al Jawder, Shaikha
collection PubMed
description 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.
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spelling pubmed-57900662018-02-07 All guns blazing: management and survival of massive valproic acid overdose – case report and literature review Al Jawder, Shaikha AlJishi, Eiman Al-Otaibi, Shaikhah Al-Shahrani, Mohammed S Open Access Emerg Med Case Report 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. Dove Medical Press 2018-01-25 /pmc/articles/PMC5790066/ /pubmed/29416381 http://dx.doi.org/10.2147/OAEM.S151095 Text en © 2018 Al Jawder et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Al Jawder, Shaikha
AlJishi, Eiman
Al-Otaibi, Shaikhah
Al-Shahrani, Mohammed S
All guns blazing: management and survival of massive valproic acid overdose – case report and literature review
title All guns blazing: management and survival of massive valproic acid overdose – case report and literature review
title_full All guns blazing: management and survival of massive valproic acid overdose – case report and literature review
title_fullStr All guns blazing: management and survival of massive valproic acid overdose – case report and literature review
title_full_unstemmed All guns blazing: management and survival of massive valproic acid overdose – case report and literature review
title_short All guns blazing: management and survival of massive valproic acid overdose – case report and literature review
title_sort all guns blazing: management and survival of massive valproic acid overdose – case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5790066/
https://www.ncbi.nlm.nih.gov/pubmed/29416381
http://dx.doi.org/10.2147/OAEM.S151095
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