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KMID : 1013220050030020126
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Jouranl of the Korean Society of Clinical Toxicology
2005 Volume.3 No. 2 p.126 ~ p.129
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A Case of Hemoperfusion and L-Carnitine Management in Valproic Acid Overdose
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Abstract
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Valproic acid (VPA) is used in the management of a variety of conditions including simple and complex absence seizure disorder. bipolar disorder, and migraine prophylaxis. Clinical manifestation of VPA overdose vary in severity from mild confusion and lethargy to severe coma and death. The treatment of VPA toxicity is mainly supportive. There is no specific antidote, nor are there specific guidelines for the management of VPA intoxication. Anecdotal reports describe the efficacy of naloxone and L-carnitine, but the data are insufficient to make strong conclusions. Various techniques of extracoporeal therapy for the management of VPA toxicity have been described, but none has prevailed as standard therapy. We report a patient with VPA overdose who was successfully treated with hemoperfusion with activated charcoal and L-carnitine. VPA levels of the patient was more than 1,000 {mu}g/ml and was normalized after 3 times hemoperfusion. The patient was injected with L-carnitine by maximum 600 mg/kg/day for 5days without complications.
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