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content:valproate [2020/02/17 11:13] – [History] icna | content:valproate [2020/02/17 12:52] – icna | ||
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====== Valproate ====== | ====== Valproate ====== | ||
- | Valproic acid (2-propyl pentanoic acid, 2-propyl valeric acid) is a short-chain branched fatty acid. Prior to the serendipitous discovery of its anti-epileptic activity in 1963, valproic acid was used as an organic solvent. | + | Valproic acid (2-propyl pentanoic acid, 2-propyl valeric acid) is a short-chain branched fatty acid. Prior to the serendipitous discovery of its anti-epileptic activity in 1963, valproic acid was used as an organic solvent[(: |
===== Authorised indications ===== | ===== Authorised indications ===== | ||
UK-SmPC: In the treatment of generalized, | UK-SmPC: In the treatment of generalized, | ||
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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 | + | |
* 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, | * an abnormally low prothrombin level, particularly in association with other relevant abnormalities, | ||
* 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. | + | |
* hyperammonaemic encephalopathy, | * hyperammonaemic encephalopathy, | ||
* Thrombocytopenia and other haematological abnormalities: | * Thrombocytopenia and other haematological abnormalities: |