Common antiepileptic drug valproic acid

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Valproic acid is a broad-spectrum antiepileptic drug. It is a white crystalline powder or granule, the taste is slightly astringent, and has

Content

Valproic acid is a broad-spectrum antiepileptic drug. It is a white crystalline powder or granule, the taste is slightly astringent, and has strong hygroscopicity. The mechanism has not been clarified, for the treatment of various types of seizures, myoclonic seizures, epilepsy, seizures and limitations of mixed type epilepsy. Serum valproic acid > 500 g/ml associated with drowsiness and slowness in clinic; > 1000 g/ml with coma and metabolic disorders (acidosis, hypocalcemia and hypernatremia) on. Valproic acid is present in the enteric liver circulation, and its active metabolite may prolong or delay toxicity.

Indications

The 1 is mainly used for absence seizure, myoclonic seizures; especially in the small of the best. The tonic clonic seizures, and sometimes also have certain effects on complex partial seizures.

2 prophylactic treatment of migraine.

Matters needing attention

1 taboo

(1) patients with hematological diseases

(2) history of liver disease

(3) impaired renal function

(4) patients with organic encephalopathy

(5) pregnant women

(6) systemic lupus erythematosus (SLE) patients with abnormal immune response after taking valproic acid

2 the impact of drugs on children

Children under 3 years of age are at risk for liver poisoning with valproic acid

3 the effect of drugs on lactation

Valproic acid can be secreted into milk, the concentration of maternal plasma concentration of 1% ~ 10%, lactating women should be paid attention to

4 Effect of drug on test value or diagnosis

(1) because of the metabolites of valproic acid in urine, the urine test may be false positive

(2) thyroid function test may be affected

(3) lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase may be slightly increased. And asymptomatic liver intoxication

(4) serum bilirubin may be elevated, suggesting a potential for severe liver toxicity

5 before and after medication and medication should be checked or monitored

(1) counts of whole blood cells (including platelets)

(2) liver and kidney function examination, liver function in the first half of the best every 1 ~ February review of 1 times, six months after the interval as appropriate

(3) monitoring plasma valproic acid concentration

Valproic acid

A new study has shown that patients with brain tumors treated with epilepsy based on standard therapy have a longer survival time than those who take other types of seizures.

Glioblastoma is the most common and malignant brain tumor in adults. Up to half of patients with glioblastoma have seizures. It is highly recommended that one of several antiepileptic drugs should be used in the treatment of patients with epilepsy. After surgery, the standard treatment for patients with newly diagnosed glioblastoma is the combination of radiotherapy and chemotherapy.

In this study, the European Organization for research and treatment of cancer (EORTC) and the National Cancer Institute of Canada Clinical Trials Group (NCIC) researchers by participating in an assessment of radiation therapy with and without temozolomide clinical trial of 573 patients with brain tumor, analysis of the use of drug treatment of epilepsy. At the start of treatment, 175 cases of patients not taking antiepileptic drugs, and 398 patients taking antiepileptic drugs, including valproic acid as its only antiepileptic drugs in 97 patients.

Research shows that at the same time, patients receiving chemotherapy and radiotherapy treatment smoothly, and those who are treated with valproic acid and prevention of epilepsy results has been further improved, the survival time than those who did not receive the drug. The average length of 3 months.

For radiotherapy and temozolomide is valproic acid in patients, although the survival time increased, but the ratio of other groups was more likely in patients with platelets and white blood cells decreased, which can increase a person's risk of infection and bleeding.

Valproic acid did not have a survival benefit for patients who did not receive temozolomide alone. Weller said further studies should be conducted on the use of valproic acid and other similar mechanisms to determine whether and why valproic acid may help patients who receive radiotherapy and temozolomide to survive longer.

 

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