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Hemodiyaliz ve L-Carnitine ile Valproik Asit Zehirlenmesinin Başarılı Tedavisi

Year 2013, Volume: 4 Issue: 1, 10 - 12, 01.01.2013

Tuğba Atmaca Temrel Seval İzdeş Gülhan Kurtoğlu Çelik Defne Altınbaş Havva Şahin Kavaklı Asliddin Ahmedali

Abstract

Valproik asit (VPA) geniş spektrumlu bir antiepileptiktir, bu nedenle yaygın olarak kullanılması özkıyım vakalarında sık karşılaşılmasına yol açmıştır. VPA toksisitesinde elektrolit bozuklukları,
hepatotoksisite, pankreatit, kemik iliği süpresyonu, beyin ödemi
görülebilir. Ancak, VPA doz aşımı tedavisi için spesifik bir antidot
yoktur. Olgu sunumları naloxone, L-karnitin ve çeşitli extrakorporeal eliminasyon tekniklerininVPA toksisitesinde etkinliğini açıklamaktadır. Biz 31 yaşında VPA intoksikasyonu bayan olgunun hemodiyaliz ve L karnitin ile başarılı tedavisini ve VPA toksisitesine
yaklaşımın literatürünün gözden geçirilmesini burada sunuyoruz.

Keywords

Valproik asit karnitin hemodiyaliz

References

  • Lheureux PE, Hantson P. Carnitine in the treatment of valproic acid- induced toxicity. Clin Toxicol (Phila) 2009; 47: 101-11. [CrossRef]
  • Mirski M. Anticonvulsants in the intensive care unit. In Textbook of Criti- cal Care. 5th Edition. Ed. Fink MP, Abraham E, Vincent JL, Kochanek P; Elsevier Saunders, 2005. p.1607-19.
  • Aaron CK. Anticonvulsants. In Irwin and Rippe’s Intensive Care Medi- cine.(5th Edition). Eds Irwin RS, Rippe JM. Lippincott Williams and Wilkins; 2003.p.1383-92.
  • Van der Wouden EA, Dekkers A, Kruis HM, van Geijlswijk IM, Tjan DH, Feith GW. Extracorporeal elimination in acute valproate intoxication. BMJ Case Rep 2009.
  • Jung J, Eo E, Ahn KO. A case of hemoperfusion and L-carnitine manage- ment in valproic acid overdose.Am J Emerg Med 2008; 26: 388.
  • Minville V, Roche Tissot C, Samii K. Haemodialysis, L-carnitine therapy and valproic acid overdose. Ann Fr Anesth Reanim 2004; 23: 357-60. [CrossRef]
  • Mock CM, Schwetschenau KH. Levocarnitine for valproic-acid-induced hyperammonemic encephalopathy. Am J Health Syst Pharm 2012; 69: 35-9. [CrossRef]
  • Perrott J, Murphy NG, Zed PJ. L-carnitine for acute valproic acid over- dose: a systematic review of published cases. Ann Pharmacother 2010; 44: 1287-93. [CrossRef]

Successful Treatment of Valproic Acid Intoxication with Hemodialysis and L-Carnitine

Year 2013, Volume: 4 Issue: 1, 10 - 12, 01.01.2013

Tuğba Atmaca Temrel Seval İzdeş Gülhan Kurtoğlu Çelik Defne Altınbaş Havva Şahin Kavaklı Asliddin Ahmedali

Abstract

Valproic acid (VPA) is a conventional antiepileptic drug and, in parallel to its widespread prescription, it has been used in many cases of suicide attempts. VPA intoxication may cause electrolyte disturbances, hepatotoxicity, pancreatitis, bone marrow suppression, and brain edema. However, there is no specific antidote for treatment of VPA overdose. Case reports describe the efficacy of naloxone, L-carnitine and various extracorporeal elimination techniques in the treatment of VPA toxicity. We present the case of a 31 year old female with VPA intoxication who was successfully treated with hemodialysis and L-carnitine, and a review of the literature on the management of VPA overdose

Keywords

Valproic acid carnitine hemodialysis

References

  • Lheureux PE, Hantson P. Carnitine in the treatment of valproic acid- induced toxicity. Clin Toxicol (Phila) 2009; 47: 101-11. [CrossRef]
  • Mirski M. Anticonvulsants in the intensive care unit. In Textbook of Criti- cal Care. 5th Edition. Ed. Fink MP, Abraham E, Vincent JL, Kochanek P; Elsevier Saunders, 2005. p.1607-19.
  • Aaron CK. Anticonvulsants. In Irwin and Rippe’s Intensive Care Medi- cine.(5th Edition). Eds Irwin RS, Rippe JM. Lippincott Williams and Wilkins; 2003.p.1383-92.
  • Van der Wouden EA, Dekkers A, Kruis HM, van Geijlswijk IM, Tjan DH, Feith GW. Extracorporeal elimination in acute valproate intoxication. BMJ Case Rep 2009.
  • Jung J, Eo E, Ahn KO. A case of hemoperfusion and L-carnitine manage- ment in valproic acid overdose.Am J Emerg Med 2008; 26: 388.
  • Minville V, Roche Tissot C, Samii K. Haemodialysis, L-carnitine therapy and valproic acid overdose. Ann Fr Anesth Reanim 2004; 23: 357-60. [CrossRef]
  • Mock CM, Schwetschenau KH. Levocarnitine for valproic-acid-induced hyperammonemic encephalopathy. Am J Health Syst Pharm 2012; 69: 35-9. [CrossRef]
  • Perrott J, Murphy NG, Zed PJ. L-carnitine for acute valproic acid over- dose: a systematic review of published cases. Ann Pharmacother 2010; 44: 1287-93. [CrossRef]
There are 8 citations in total.

Details

Other ID JA83AR55SF
Journal Section Case Report
Authors

Tuğba Atmaca Temrel This is me

Seval İzdeş This is me

Gülhan Kurtoğlu Çelik This is me

Defne Altınbaş This is me

Havva Şahin Kavaklı This is me

Asliddin Ahmedali This is me

Publication Date January 1, 2013
Submission Date January 1, 2013
Published in Issue Year 2013 Volume: 4 Issue: 1

Cite

APA Temrel, T. A., İzdeş, S., Çelik, G. K., Altınbaş, D., et al. (2013). Successful Treatment of Valproic Acid Intoxication with Hemodialysis and L-Carnitine. Journal of Emergency Medicine Case Reports, 4(1), 10-12.
AMA Temrel TA, İzdeş S, Çelik GK, Altınbaş D, Kavaklı HŞ, Ahmedali A. Successful Treatment of Valproic Acid Intoxication with Hemodialysis and L-Carnitine. Journal of Emergency Medicine Case Reports. January 2013;4(1):10-12.
Chicago Temrel, Tuğba Atmaca, Seval İzdeş, Gülhan Kurtoğlu Çelik, Defne Altınbaş, Havva Şahin Kavaklı, and Asliddin Ahmedali. “Successful Treatment of Valproic Acid Intoxication With Hemodialysis and L-Carnitine”. Journal of Emergency Medicine Case Reports 4, no. 1 (January 2013): 10-12.
EndNote Temrel TA, İzdeş S, Çelik GK, Altınbaş D, Kavaklı HŞ, Ahmedali A (January 1, 2013) Successful Treatment of Valproic Acid Intoxication with Hemodialysis and L-Carnitine. Journal of Emergency Medicine Case Reports 4 1 10–12.
IEEE T. A. Temrel, S. İzdeş, G. K. Çelik, D. Altınbaş, H. Ş. Kavaklı, and A. Ahmedali, “Successful Treatment of Valproic Acid Intoxication with Hemodialysis and L-Carnitine”, Journal of Emergency Medicine Case Reports, vol. 4, no. 1, pp. 10–12, 2013.
ISNAD Temrel, Tuğba Atmaca et al. “Successful Treatment of Valproic Acid Intoxication With Hemodialysis and L-Carnitine”. Journal of Emergency Medicine Case Reports 4/1 (January 2013), 10-12.
JAMA Temrel TA, İzdeş S, Çelik GK, Altınbaş D, Kavaklı HŞ, Ahmedali A. Successful Treatment of Valproic Acid Intoxication with Hemodialysis and L-Carnitine. Journal of Emergency Medicine Case Reports. 2013;4:10–12.
MLA Temrel, Tuğba Atmaca et al. “Successful Treatment of Valproic Acid Intoxication With Hemodialysis and L-Carnitine”. Journal of Emergency Medicine Case Reports, vol. 4, no. 1, 2013, pp. 10-12.
Vancouver Temrel TA, İzdeş S, Çelik GK, Altınbaş D, Kavaklı HŞ, Ahmedali A. Successful Treatment of Valproic Acid Intoxication with Hemodialysis and L-Carnitine. Journal of Emergency Medicine Case Reports. 2013;4(1):10-2.