The DOI matches its Crossref record; 57 of the 57 references it cites were found in a registry or an index.
Valproic Acid Toxicity: Overview and Management
Abstract
Acute valproic acid intoxication is an increasing problem, accounting for more than 5000 calls to the American Association of Poison Control Centers in 2000. The purpose of this paper is to review the pharmacology and toxicology of valproic acid toxicity. Unlike earlier antiepileptic agents, valproic acid appears to function neither through sodium channel inhibition nor through direct gamma-aminobutyric acid agonism, but through an indirect increase in regional brain gamma-aminobutyric acid levels. Manifestations of acute valproic acid toxicity are myriad, and reflect both exaggerated therapeutic effect and impaired intermediary metabolism. Central nervous system depression is the most common finding noted in overdose, and may progress to coma and respiratory depression. Cerebral edema has also been observed. Although hepatotoxicity is rare in the acute overdose setting, pancreatitis and hyperammonemia have been reported. Metabolic and hematologic derangements have also been described. Management of acute valproic acid ingestion requires supportive care and close attention to the airway. The use of controversial adjunctive therapies, including extracorporeal drug elimination and L-carnitine supplementation, will be discussed.
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Valproic acid hepatic fatalities: A retrospective review
Dreifuss, F. E., Santilli, N., Langer, D. H., Sweeney, K. P., Moline, K. A., & Menander, K. B. (1987) · Neurology · doi:10.1212/wnl.37.3.379 · Cited by 483
Litovitz, T. L., Schmitz, B. F., & Holm, K. C. (1989) · The American Journal of Emergency Medicine · doi:10.1016/0735-6757(89)90252-0 · Cited by 410
Mechanisms of action of valproate: a commentatory
Johannessen, C. (2000) · Neurochemistry International · doi:10.1016/s0197-0186(00)00013-9 · Cited by 399
American Academy of Clinical Toxicology, E. A. O. P. C. A. C. T. (1999) · Journal of Toxicology: Clinical Toxicology · doi:10.1081/clt-100102451 · Cited by 397
Litovitz, T. L., Klein-Schwartz, W., White, S., Cobaugh, D. J., Youniss, J., Omslaer, J. C., Drab, A., & Benson, B. E. (2001) · The American Journal of Emergency Medicine · doi:10.1053/ajem.2001.25272 · Cited by 392
(1997) · Journal of Toxicology: Clinical Toxicology · doi:10.3109/15563659709162569 · Cited by 386
Litovitz, T. L., Felberg, L., White, S., & Klein-Schwartz, W. (1996) · The American Journal of Emergency Medicine · doi:10.1016/s0735-6757(96)90160-6 · Cited by 309
McLean, M. J., & Macdonald, R. L. (1986) · The Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)24966-7 · Cited by 273
Kesterson, J. W., Granneman, R. G., & Machinist, J. M. (1984) · Hepatology · doi:10.1002/hep.1840040609 · Cited by 250
Cytochrome P-450—Catalyzed Formation of Δ4-VPA, a Toxic Metabolite of Valproic Acid
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European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances
Lott, C., Truhlář, A., Alfonzo, A., Barelli, A., González-Salvado, V., Hinkelbein, J., Nolan, J. P., Paal, P., Perkins, G. D., Thies, K.-C., et al. (2021) · Resuscitation · doi:10.1016/j.resuscitation.2021.02.011 · Cited by 789
Lheureux (2005) · doi:10.1186/cc3742 · Cited by 176
Waldmann, T., Rempel, E., Balmer, N. V., König, A., Kolde, R., Gaspar, J. A., Henry, M., Hescheler, J., Sachinidis, A., Rahnenführer, J., et al. (2014) · Chemical Research in Toxicology · doi:10.1021/tx400402j · Cited by 106
Drug-Induced Liver Injury in Children
Amin, M. D., Harpavat, S., & Leung, D. H. (2015) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000000264 · Cited by 29
Metadata
- Authors
- Sztajnkrycer, M. D.
- Venue
- Journal of Toxicology: Clinical Toxicology
- Publisher
- Informa UK Limited
- Published
- 2002-01
- Volume
- 40
- Issue
- 6
- Pages
- 789-801
- ISSN
- 0731-3810 (ISSN-L)
- OpenAlex
- W2109115714
- Cited by
- 286
- References
- 57
- FWCI
- 8.48
- Type
- journal article
- Language
- en
- Open access
- closed
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Data sources
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
