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Hiperamonyeminin Nadir Bir Nedeni: Valproik Asit Zehirlenmesi

Year 2015, Volume: 6 Issue: 3, 60 - 62, 01.07.2015

Duygu Selen Cengiz Muhammed Semih Gedik Müge Gülen Erdem Aksay Hayri Çınar Selen Acehan Akkan Avcı

Abstract

Giriş: Valproik asit (VA) epilepsi ve bipolar duygu durum
bozukluğu tedavisinde ayrıca migren profilaksisinde yaygın olarak
kullanılan geniş spektrumlu bir antiepileptiktir. Yüksek doz alımlar,
letarjiden komaya kadar değişen merkezi sinir sistemi (MSS)
depresyonuna, solunum yetmezliğine, böbrek yetmezliğine,
akut pankreatite, hepatotoksisiteye ve kemik iliği depresyonuna
neden olabilmektedir.
Olgu Sunumu: Biz bu yazıda akut masif doz VA’ in neden olduğu
hiperamonyemik ensefalopatili olgunun L-karnitin ile tedavisini
son literatürler ışığında incelemeye çalıştık.
Sonuç: Acil servislerde (AS) nadir görülen bir zehirlenme olan
VA zehirlenmelerinde; ciddi zehirlenme bulguları ile beraber
hiperamonyemi varsa L-karnitin tedavisi akılda tutulması gereken
bir tedavi yaklaşımıdır.

Keywords

Valproik asit zehirlenme hiperamonyemi L-karnitin

References

  • Temrel TA, İzdeş S, Celik GK, Altıntaş D, Kavaklı HŞ, Ahmedali A. Suc- cessful treatment of valproic acid ıntoxication with hemodialysis and l-carnitine. JAEMCR 2013; 4: 10-2. [CrossRef]
  • Satar S, Bozdemir MN. Antiepiletik ilaçlarla zehirlenmeler. Acilde Klinik Toksikoloji. Adana: Nobel Tıp Kitabevi, 1th ed. 2009 p. 331-37.
  • Sztajnkrycer MD. Valproic acid toxicity: Overview and management. J Toxicol Clin Toxicol 2002; 40: 789-01. [CrossRef]
  • Al Aly Z, Yalamanchili P, Gonzalez E. Extracorporeal management of valproic acid toxicity: A case report and review of the literature. Semin Dial 2005; 18: 62-6.
  • Temel V, Arikan M, Temel G. High-flux hemodialysis and levocarnitine in the treatment of severe valproic acid ıntoxication. Hindawi Publishing Corporation Case Reports in Emergency Medicine Vol. 2013, Article ID 526469, 3 pages, 2013.
  • Eryılmaz G, Gül IG, Ünsalver BÖ, Salçini C, Sağlam E. Valproik asit kullanı- mına bağlı gelişen hiperamonyemik ensefalopati: Vaka sunumu. Jour- nal of Mood Disorders 2014; 4: 182-5.
  • Perrott J, Murphy NG, Zed PJ. L-carnitine for acute valproic acid overdo- se: A systematic review of published cases. Ann Pharmacother 2010; 44: 1287-93. [CrossRef]
  • Eyer F, Felgenhauer N, Gempel K, Steimer W, Gerbitz KD, Zilker T. Acute valproate poisoning: Pharmacokinetics, alteration in fatty acid meta- bolism, and changes during therapy. J Clin Psychopharmacol 2005; 25: 376-80. [CrossRef]
  • Spiller HA, Krenzelok EP, Klein-Schwartz W, Winter ML, Weber JA, Sollee DR, et al. Multicenter case series of valproic acid ingestion: Serum con- centrations and toxicity. J Toxicol Clin Toxicol 2000; 38: 755-60. [CrossRef]
  • Malaguarnera M, Vacante M, Motta M, Giordano M, Malaguarnera G, Bella R, et al. Acetyl-L-carnitine improves cognitive functions in seve- re hepatic encephalopathy: A randomized and controlled clinical trial. Metab Brain Dis 2011; 26: 281-9.[CrossRef]

A Rare Reason of Hyperammonemia: Valproic Acid Poisoning

Year 2015, Volume: 6 Issue: 3, 60 - 62, 01.07.2015

Duygu Selen Cengiz Muhammed Semih Gedik Müge Gülen Erdem Aksay Hayri Çınar Selen Acehan Akkan Avcı

Abstract

Introduction: Valproic acid (VA) is a broad-spectrum antiepileptic drug that is widely used in the treatment of epilepsy and bipolar affective disorder and also in the prophylaxis of migraine. High doses can cause central nervous system depression ranging from lethargy to coma, respiratory failure, renal failure, acute pancreatitis, hepatotoxicity, and bone marrow depression.Case Report: In this paper, we attempted to examine a case of acute encephalopathy with hyperammonemia caused by high doses of VA and treated with L-carnitine based on the recent literature.Conclusion: In patients with hyperammonemia associated with the severe toxicity symptoms of poisoning, L-carnitine administration is a treatment approach to keep in mind based on the rare types of poisoning observed at emergency services

Keywords

Valproic acid poisoning hyperammonemia L-carnitine

References

  • Temrel TA, İzdeş S, Celik GK, Altıntaş D, Kavaklı HŞ, Ahmedali A. Suc- cessful treatment of valproic acid ıntoxication with hemodialysis and l-carnitine. JAEMCR 2013; 4: 10-2. [CrossRef]
  • Satar S, Bozdemir MN. Antiepiletik ilaçlarla zehirlenmeler. Acilde Klinik Toksikoloji. Adana: Nobel Tıp Kitabevi, 1th ed. 2009 p. 331-37.
  • Sztajnkrycer MD. Valproic acid toxicity: Overview and management. J Toxicol Clin Toxicol 2002; 40: 789-01. [CrossRef]
  • Al Aly Z, Yalamanchili P, Gonzalez E. Extracorporeal management of valproic acid toxicity: A case report and review of the literature. Semin Dial 2005; 18: 62-6.
  • Temel V, Arikan M, Temel G. High-flux hemodialysis and levocarnitine in the treatment of severe valproic acid ıntoxication. Hindawi Publishing Corporation Case Reports in Emergency Medicine Vol. 2013, Article ID 526469, 3 pages, 2013.
  • Eryılmaz G, Gül IG, Ünsalver BÖ, Salçini C, Sağlam E. Valproik asit kullanı- mına bağlı gelişen hiperamonyemik ensefalopati: Vaka sunumu. Jour- nal of Mood Disorders 2014; 4: 182-5.
  • Perrott J, Murphy NG, Zed PJ. L-carnitine for acute valproic acid overdo- se: A systematic review of published cases. Ann Pharmacother 2010; 44: 1287-93. [CrossRef]
  • Eyer F, Felgenhauer N, Gempel K, Steimer W, Gerbitz KD, Zilker T. Acute valproate poisoning: Pharmacokinetics, alteration in fatty acid meta- bolism, and changes during therapy. J Clin Psychopharmacol 2005; 25: 376-80. [CrossRef]
  • Spiller HA, Krenzelok EP, Klein-Schwartz W, Winter ML, Weber JA, Sollee DR, et al. Multicenter case series of valproic acid ingestion: Serum con- centrations and toxicity. J Toxicol Clin Toxicol 2000; 38: 755-60. [CrossRef]
  • Malaguarnera M, Vacante M, Motta M, Giordano M, Malaguarnera G, Bella R, et al. Acetyl-L-carnitine improves cognitive functions in seve- re hepatic encephalopathy: A randomized and controlled clinical trial. Metab Brain Dis 2011; 26: 281-9.[CrossRef]
There are 10 citations in total.

Details

Other ID JA39ZZ93ZH
Journal Section Case Report
Authors

Duygu Selen Cengiz This is me

Muhammed Semih Gedik

Müge Gülen

Erdem Aksay This is me

Hayri Çınar This is me

Selen Acehan This is me

Akkan Avcı This is me

Publication Date July 1, 2015
Submission Date July 1, 2015
Published in Issue Year 2015 Volume: 6 Issue: 3

Cite

APA Cengiz, D. S., Gedik, M. S., Gülen, M., Aksay, E., et al. (2015). A Rare Reason of Hyperammonemia: Valproic Acid Poisoning. Journal of Emergency Medicine Case Reports, 6(3), 60-62.
AMA Cengiz DS, Gedik MS, Gülen M, Aksay E, Çınar H, Acehan S, Avcı A. A Rare Reason of Hyperammonemia: Valproic Acid Poisoning. Journal of Emergency Medicine Case Reports. July 2015;6(3):60-62.
Chicago Cengiz, Duygu Selen, Muhammed Semih Gedik, Müge Gülen, Erdem Aksay, Hayri Çınar, Selen Acehan, and Akkan Avcı. “A Rare Reason of Hyperammonemia: Valproic Acid Poisoning”. Journal of Emergency Medicine Case Reports 6, no. 3 (July 2015): 60-62.
EndNote Cengiz DS, Gedik MS, Gülen M, Aksay E, Çınar H, Acehan S, Avcı A (July 1, 2015) A Rare Reason of Hyperammonemia: Valproic Acid Poisoning. Journal of Emergency Medicine Case Reports 6 3 60–62.
IEEE D. S. Cengiz, “A Rare Reason of Hyperammonemia: Valproic Acid Poisoning”, Journal of Emergency Medicine Case Reports, vol. 6, no. 3, pp. 60–62, 2015.
ISNAD Cengiz, Duygu Selen et al. “A Rare Reason of Hyperammonemia: Valproic Acid Poisoning”. Journal of Emergency Medicine Case Reports 6/3 (July 2015), 60-62.
JAMA Cengiz DS, Gedik MS, Gülen M, Aksay E, Çınar H, Acehan S, Avcı A. A Rare Reason of Hyperammonemia: Valproic Acid Poisoning. Journal of Emergency Medicine Case Reports. 2015;6:60–62.
MLA Cengiz, Duygu Selen et al. “A Rare Reason of Hyperammonemia: Valproic Acid Poisoning”. Journal of Emergency Medicine Case Reports, vol. 6, no. 3, 2015, pp. 60-62.
Vancouver Cengiz DS, Gedik MS, Gülen M, Aksay E, Çınar H, Acehan S, Avcı A. A Rare Reason of Hyperammonemia: Valproic Acid Poisoning. Journal of Emergency Medicine Case Reports. 2015;6(3):60-2.