content:valproate

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content:valproate [2020/02/17 11:13] – [History] icnacontent:valproate [2020/02/17 11:15] – [Main ADRs] icna
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 **Systemic:** **Systemic:**
-  * the most serious are fatal hepatotoxicity and acute haemorrhagic pancreatitis. +  * the most serious are **fatal hepatotoxicity** and **acute haemorrhagic pancreatitis**. 
-  * fatal hepatotoxicity+  * **fatal hepatotoxicity**
     * primarily age-dependent and occurs mainly in children receiving polypharmacy and with organic brain disease     * primarily age-dependent and occurs mainly in children receiving polypharmacy and with organic brain disease
     * the risk is 1/600 before the age of 3 years.     * the risk is 1/600 before the age of 3 years.
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     * an abnormally low prothrombin level, particularly in association with other relevant abnormalities, requires withdrawal of valproate.     * an abnormally low prothrombin level, particularly in association with other relevant abnormalities, requires withdrawal of valproate.
     * any concomitant use of salicylates should be stopped, since they employ the same metabolic pathway.     * any concomitant use of salicylates should be stopped, since they employ the same metabolic pathway.
-  * acute haemorrhagic pancreatitis with markedly increased amylase and lipase levels is another rare, but serious, adverse effect of valproate treatment. It develops within the first 3 months of treatment, is more prevalent in children and with polytherapy.+  * **acute haemorrhagic pancreatitis** with markedly increased amylase and lipase levels is another rare, but serious, adverse effect of valproate treatment. It develops within the first 3 months of treatment, is more prevalent in children and with polytherapy.
   * hyperammonaemic encephalopathy, which is sometimes fatal, has been reported following initiation of valproate therapy in patients with urea cycle disorders. When urea cycle enzymatic deficiency is suspected, metabolic investigations should be performed prior to treatment with valproate.   * hyperammonaemic encephalopathy, which is sometimes fatal, has been reported following initiation of valproate therapy in patients with urea cycle disorders. When urea cycle enzymatic deficiency is suspected, metabolic investigations should be performed prior to treatment with valproate.
   * Thrombocytopenia and other haematological abnormalities:it is recommended that platelet counts and coagulation tests are performed before initiating therapy and at periodic intervals, because of reports of thrombocytopenia, inhibition of the secondary phase of platelet aggregation and abnormal coagulation parameters.   * Thrombocytopenia and other haematological abnormalities:it is recommended that platelet counts and coagulation tests are performed before initiating therapy and at periodic intervals, because of reports of thrombocytopenia, inhibition of the secondary phase of platelet aggregation and abnormal coagulation parameters.
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