Valproate Toxicity Questions & Answers

Updated: May 30, 2020
  • Author: Asim A Abbasi, MD, FAAP; Chief Editor: Michael A Miller, MD  more...
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Questions & Answers

Overview

What is valproate toxicity?

What are the signs and symptoms of valproate toxicity?

Which altered vital signs are characteristic of valproate toxicity?

Which CNS findings suggest valproate overdose?

Which physical findings suggest valproate toxicity?

Which lab studies are performed in the diagnosis of valproate toxicity?

Which imaging studies may be performed in the diagnosis of valproate toxicity?

What is included in the initial stabilization and resuscitation of patients with valproate toxicity?

Which decontamination methods are used in the treatment of valproate toxicity?

How are elimination-enhancing procedures used in the treatment of valproate toxicity?

Which medications are used in the treatment of valproate toxicity?

What is valproate toxicity?

How does valproate toxicity occur?

What is the role of absorption in the pharmacokinetics of valproate toxicity?

What is the role of volume of distribution in the pharmacokinetics of valproate toxicity?

What is the role of protein binding in the pharmacokinetics of valproate toxicity?

What is the role of metabolism in the pharmacokinetics of valproate toxicity?

What is the elimination half-life for valproate?

Which dosing and drug interactions lead to valproate toxicity?

What are the pharmacokinetic mechanisms of valproate toxicity?

What is the annual incidence of valproate toxicity?

Which age groups are at highest risk for valproate toxicity?

What is the prognosis of valproate toxicity?

Presentation

Which clinical history findings are characteristic of valproate toxicity?

Which physical findings are characteristic of valproate toxicity?

Which altered vital signs suggest valproate toxicity?

What are the CNS manifestations of valproate overdose?

Which physical findings are characteristic of valproate toxicity?

DDX

What are the differential diagnoses for Valproate Toxicity?

Workup

Which lab tests should be performed in the workup of valproate toxicity?

What is the role of serum chemistries in the diagnosis of valproate toxicity?

What is the role of liver function studies in the workup of valproate toxicity?

Why is respiratory depression with hypercapnia assessed in the workup of valproate toxicity?

How frequently is an anion gap present during the workup for valproate toxicity?

Which lab tests may be helpful in the workup of valproate toxicity?

What is the role of CT scanning in the workup of valproate toxicity?

What is the role of electrocardiography in the workup of valproate toxicity?

Treatment

What is included in the treatment of valproate toxicity?

What is included in the initial stabilization and resuscitation of patients with valproate toxicity?

Which decontamination methods are used in the treatment of valproate toxicity?

When are procedures to enhance elimination indicated in the treatment of valproate toxicity?

What is the role of hemodialysis and hemoperfusion in the treatment of valproate toxicity?

What is the role of continuous venovenous hemodialysis (CVVHD) in the treatment of valproate toxicity?

What is the role of multidose activated charcoal in the treatment of valproate toxicity?

What is the role of naloxone in the treatment of valproate toxicity?

What is the role of L-carnitine (levocarnitine) in the treatment of valproate toxicity?

What is the efficacy of L-carnitine oral supplementation for treatment of valproate toxicity?

Which specialist consultations are beneficial for patients with valproate toxicity?

Medications

Which medications are used in the treatment of valproate toxicity?

Which medications in the drug class Antidotes are used in the treatment of Valproate Toxicity?

Follow-up

What long-term care is needed following treatment for valproate toxicity?

What is included in inpatient care for valproate toxicity?

When is patient transfer indicated in the treatment of valproate toxicity?

What are complications of valproate toxicity?