<b>A Case of Valproate Overdose Complicated by Severe Hyperammonemia that was Ameliorated with Time Concomitant with Decline in Serum Valproate Concentration</b>
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- ITOH Terumi
- Department of Pharmacy, Tenshi Hospital
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- KONDA Ainari
- Division of Clinical Pharmacology, Hokkaido Pharmaceutical University School of Pharmacy
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- YASUDA Sachiko
- Department of Pharmacy, Tenshi Hospital
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- FUJIMURA Takuya
- Department of Pharmacy, Tenshi Hospital
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- SOMA Mayuko
- Department of Pharmacy, Tenshi Hospital
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- SASAKI Yoichi
- Department of Pharmacy, Tenshi Hospital
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- MUKAI Yuji
- Division of Clinical Pharmacology, Hokkaido Pharmaceutical University School of Pharmacy
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- TODA Takaki
- Division of Clinical Pharmacology, Hokkaido Pharmaceutical University School of Pharmacy
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- TSUJISAKI Masayuki
- Department of Gastroenterology, Tenshi Hospital
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- INOTSUME Nobuo
- Division of Clinical Pharmacology, Hokkaido Pharmaceutical University School of Pharmacy
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A 26-year-old man treated for epilepsy with sodium valproate (VPA-Na, 800 mg/day) was admitted to the emergency room with dehydration, poor appetite, fatigue, arthralgia and general malaise. He stated that he had taken 50 VPA-Na tablets at 12:00 midnight because he was hungry. Clinical findings on admission included blood pressure, 106/60 mmHg; body temperature, 36.9℃; percutaneous oxygen saturation, 98%; plasma total protein, 5.9 g/dL; and plasma ammonia level, 291 μg/dL. Markers of hepatic and renal functions and amylase levels were all within normal ranges. Serum total and free VPA concentrations at 16 h after VPA-Na ingestion were respectively 218 and 98 μg/mL, decreasing to 122 and 31 μg/mL at 31 h, and 66 and 11 μg/mL at 55 h after ingestion. Plasma ammonia level correlated linearly with both serum total and unbound VPA concentrations, but the correlation coefficient (r) for the latter (0.980) tended to be greater than that for the former (0.998). These results suggest that serum unbound VPA concentration may be a better biomarker for predicting the time course of hyperammonemia in patients with VPA intoxication.
収録刊行物
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- 臨床薬理
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臨床薬理 46 (2), 77-79, 2015
一般社団法人 日本臨床薬理学会
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詳細情報 詳細情報について
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- CRID
- 1390001205368099584
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- NII論文ID
- 130005064873
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- ISSN
- 18828272
- 03881601
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
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- 抄録ライセンスフラグ
- 使用不可