• 제목/요약/키워드: valproic acid

검색결과 89건 처리시간 0.024초

Valproic acid와 Carbapenem계 항생제 병용 투여로 인한 Valproic acid의 약동학적 변화 및 경련 발생에 대한 고찰 (The effect of Valproic acid - Carbapenem antibiotics Interaction on Pharmacokinetics of Valproic acid and Seizure Development)

  • 서희남
    • 한국임상약학회지
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    • 제22권3호
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    • pp.234-238
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    • 2012
  • Background: Valproic acid is widely used in the treatment of generalized tonic-clonic and partial seizures. The carbapenem class is the most potent and widest spectrum of antimicrobial activity. Concomitant administration of carbapenems and valproic acid has been reported to decrease the serum concentration of valproic acid, which is sometimes associated with seizures. The purpose of this study is to evaluate the changes in valproic acid concentration and half life and the frequency of seizure during concomitant administration of valproic acid and carbapenems. Method: This study was performed retrospectively on total 40 cases with identified valproic acid concentration during concomitant administration of valproic acid and carbapenems at Kangbuk Samsung Hospital from February 1st, 2006 to October 31st, 2011. Patients were classified into 3 groups: ertapenem group (n=14), imipenem group (n=12), meropenem group (n=14). Results: The mean serum concentrations in each group during combined treatment were $9.50{\pm}8.84$, $21.88{\pm}8.17$ and $10.62{\pm}8.67$ mg/L, respectively (p < 0.001). The mean half-lives in each group during concurrent use of valproic acid and carbapenems were $3.18{\pm}0.81$, $4.63{\pm}1.97$ and $2.67{\pm}1.69$ hr, respectively (p < 0.001). The valproic acid serum concentration decreased by 75.5%, 54.1% and 84.1% and the half-life of valporoic acid decreased by 65.6%, 35.7% and 73.5%, respectively. Total cases with seizure were 12(30%) with 5(35.7%) in the ertapenem group, 3 (25.0%) in the imipenem group and 4(28.6%) in the meropenem group (p=0.911). There were no specific factors to influence on seizure development during combined treatment. Conclusion: Concurrent use of carbapenems and valproic acid should be avoided. If concomitant administration is essential, very close serum concentration monitoring and clinical observation are necessary.

발프로익산이 인체 테논낭 섬유아세포의 생존에 미치는 영향 (Effects of Valproic Acid on the Survival of Human Tennon's Capsule Fibroblasts)

  • 이시은;김재우
    • 대한안과학회지
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    • 제59권11호
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    • pp.1056-1061
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    • 2018
  • 목적: 발프로익산이 배양된 인체 테논낭 섬유아세포의 생존에 미치는 영향에 대해 알아보고자 하였다. 대상과 방법: 일차배양한 섬유아세포에 0, 0.25, 0.5, 1.0 mM 발프로익산과 0, 1.0, $2.5{\mu}g/mL$ 미토마이신 C에 각각 또는 동시에 5일간 노출시킨 후 MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay를 이용하여 세포의 생존을 측정하였고, annexin-V/propidium iodide 이중염색 후 유세포 분석을 이용하여 세포고사의 정도를 측정하였다. 결과: 발프로익산은 농도에 비례하여 섬유아세포의 생존을 유의하게 저하시켰으며, 미토마이신 C를 추가한 경우 섬유아세포의 생존을 더욱 저하시켰다. 두 약제 모두 섬유아세포의 세포고사를 유발하였으나 발프로익산은 미토마이신 C에 비해 세포고사를 적게 유발하였다. 결론: 발프로익산은 섬유아세포의 생존을 저하시키며 세포고사를 유발한다. 또한 미토마이신 C를 병용한 경우 섬유아세포에 대한 항증식효과가 더 나타날 것으로 생각된다.

Epigenetically Upregulated T-Type Calcium Channels Contribute to Abnormal Proliferation of Embryonic Neural Progenitor Cells Exposed to Valproic Acid

  • Kim, Ji-Woon;Oh, Hyun Ah;Kim, Sung Rae;Ko, Mee Jung;Seung, Hana;Lee, Sung Hoon;Shin, Chan Young
    • Biomolecules & Therapeutics
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    • 제28권5호
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    • pp.389-396
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    • 2020
  • Valproic acid is a clinically used mood stabilizer and antiepileptic drug. Valproic acid has been suggested as a teratogen associated with the manifestation of neurodevelopmental disorders, such as fetal valproate syndrome and autism spectrum disorders, when taken during specific time window of pregnancy. Previous studies proposed that prenatal exposure to valproic acid induces abnormal proliferation and differentiation of neural progenitor cells, presumably by inhibiting histone deacetylase and releasing the condensed chromatin structure. Here, we found valproic acid up-regulates the transcription of T-type calcium channels by inhibiting histone deacetylase in neural progenitor cells. The pharmacological blockade of T-type calcium channels prevented the increased proliferation of neural progenitor cells induced by valproic acid. Differentiated neural cells from neural progenitor cells treated with valproic acid displayed increased levels of calcium influx in response to potassium chloride-induced depolarization. These results suggest that prenatal exposure to valproic acid up-regulates T-type calcium channels, which may contribute to increased proliferation of neural progenitor cells by inducing an abnormal calcium response and underlie the pathogenesis of neurodevelopmental disorders.

Valproic Acid 복용에 의해 유발된 연축성 발성장애 1예 (Spasmodic Dysphonia Induced by Valproic Acid)

  • 오지영;조현지;박기덕;정성민
    • 대한후두음성언어의학회지
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    • 제14권1호
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    • pp.54-56
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    • 2003
  • Spasmodic dysphonia is a task-specific dystonia affecting the laryngeal muscles, resulting forced, strained voice. The pathophysiologic mechanism is not fully understood. We experienced a patient with epilepsy developed transient spasmodic dysphonia during valproic acid monotherapy. The spasmodic dysphonia resolved with dose reduction of valproic acid. Change of neurotransmitters, such as GABA in basal ganglia or blockade of sodium channel is possible mechanism in our case of drug-related spasmodic dysphonia.

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Valproic Acid-Induced Hyperammonemic Encephalopathy as a Cause of Neurologic Deterioration after Unruptured Aneurysm Surgery

  • Lee, Sangkook;Cheong, Jinhwan;Kim, Choonghyun;Kim, Jae Min
    • Journal of Korean Neurosurgical Society
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    • 제58권2호
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    • pp.159-162
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    • 2015
  • Neurological deficits after brain surgery are not uncommon, and correct and prompt differential diagnosis is essential to initiate appropriate treatment. We describe a patient suffering from loss of consciousness due to hyperammonemia, following valproic acid treatment after surgery for an unruptured cerebral aneurysm. A 57-year-old female patient underwent successful aneurysmal neck clipping to correct an unruptured aneurysm. Her postoperative course was good, and she received anti-epileptic therapy (valproic acid) and a soft diet. Within a few days the patient experienced mental deterioration. Her serum valproic acid reached toxic levels (149.40 mg/L), and serum ammonia was fifteen times the upper normal limit (553 mmol/L; normal range, 9-33 mmol/L). After discontinuation of valproic acid and with conservative treatment, the patient recovered without any complications. Valproate-induced hyperammonemic encephalopathy is an unusual but serious neurosurgical complication, and should not be disregarded as a possible cause of neurological deficits after neurovascular surgery. Early diagnosis is crucial, as discontinuation of valproic acid therapy can prevent serious complications, including death.

급성 Valproic acid 중독에서 L-carnitine과 체외 제거방법: 체계적 고찰 (L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication: A Systematic Review)

  • 양병근;구재은;주영선;유제성;정성필;이한식
    • 대한임상독성학회지
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    • 제12권2호
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    • pp.39-45
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    • 2014
  • Purpose: The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication Methods: PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Results: Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs 11 days) in case of delayed extracorporeal therapy. Conclusion: Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

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양극성장애에 대한 Valproic Acid와 Olanzapine 치료 중 발생한 호산구증가증과 전신증상을 동반한 약물발진(DRESS) 증후군 1예 (A Case of Drug Rash with Eosinophilia and Systemic Symptoms Associated with Valproic Acid and Olanzapine Treatment in Patient with Bipolar Disorder)

  • 이웅;임세원
    • 생물정신의학
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    • 제24권3호
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    • pp.162-166
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    • 2017
  • Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, medication-induced hypersensitivity reaction with long latency. It is characterized by fever, rash, leukocytosis with eosinophilia, atypical lymphocytosis, and internal organ involvement. The most common causes of DRESS syndrome are sulfonamides and anticonvulsants such as carbamazepine and lamotrigine. However, valproic acid and olanzapine could develop DRESS syndrome. We report a case of DRESS syndrome associated with valproic acid and olanzapine in a 41 years old male patient with bipolar disorder.

A Case of Drug-Induced Interstitial Pneumonitis Caused by Valproic Acid for the Treatment of Seizure Disorders

  • Kim, Se Jin;Jhun, Byung Woo;Lee, Ji Eun;Kim, Kang;Choi, Hyeun Yong
    • Tuberculosis and Respiratory Diseases
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    • 제77권3호
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    • pp.145-148
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    • 2014
  • Valproic acid is one of the most common antiepileptic drugs used for the treatment of several seizure disorders. A 20-year-old man presented with a sudden decline of consciousness. He had a neurosurgery operation for intracranial and intraventricular hemorrhage. Following surgery, antiepileptic medication was administered to the patient in order to control his seizure events. On valproic acid treatment, he began to complain of fever and dyspnea. His symptoms persisted despite receiving empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation and ground-glass opacities in both lower lobes. The primary differential was drug associated with interstitial lung disease. Therefore, we discontinued valproic acid treatment and began methylprednisolone treatment. His symptoms and radiologic findings had significantly improved after receiving steroid therapy. We propose that clinicians should be made aware of the potential for valproic acid to induce lung injury.

Rapid and Sensitive Analysis of Valproic Acid in Human Red Blood Cell by LC-MS/MS

  • Han, Song-Hee;Kim, Yun-Jeong;Jeon, Ji-Young;Hwang, Min-Ho;Im, Yong-Jin;Jeong, Jin-A;Lee, Chang-Seop;Chae, Soo-Wan;Kim, Min-Gul
    • Bulletin of the Korean Chemical Society
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    • 제33권5호
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    • pp.1681-1685
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    • 2012
  • A sensitive liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed to determine valproic acid in human red blood cell (RBC). It is important to measure the drug concentration of the RBC as well as that of the plasma because of drug partitioning for pharmacokinetic and pharmacodynamic study. The method was linear over the dynamic range of 1-100 ${\mu}g$/mL with a correlation coefficient $r$ = 0.9997. The linearity of this method was established from 1 to 100 ${\mu}g$/mL for valproic acid in red blood cell with accuracy and precision within 15% at all concentrations. The intra-run and inter-run assay accuracy and coefficient of variations are all within 15% for all QC samples prepared in plasma and red blood human samples. Then, valproic acid amount by protein precipitation in plasma was quantified by LC-MS/MS mass spectrometry. The distribution ratio of VPA in RBC and plasma was analyzed by clinical samples. Based on measurement of the valproic acid in human red blood cell, this method has been applied to clinical research for study of distribution ratio of valproic acid in blood.

Valproic Acid 투여로 인한 약인성 떨림 환자의 한방 치료 치험 1례 (A Case Report of Valproic Acid-Induced Tremor by Korean Traditional Medicine)

  • 장한솔;하유빈;정승현
    • 대한한방내과학회지
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    • 제42권6호
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    • pp.1319-1330
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    • 2021
  • A 56-year-old male patient with a sudden onset of tremor and involuntary movement of right upper and lower extremities, head, and voice was diagnosed as having a drug-induced tremor, with valproic acid being the culprit drug. The patient had undergone admission treatment at an internal Korean medicine department with herbal medicine according to constitutional diagnosis, acupuncture, moxibustion, cupping, and rehabilitation. The change in the severity of tremor was assessed with the Fahn Tolosa Marine scale. After discharge, the patient took herbal medicine for two more months. After 20 days of admission and 2 months of treatment with herbal medicine, the patient's tremor improved. In this case, the patient with valproic acid-induced tremor showed improvement in symptoms after 20 days of hospitalization and further reduction of tremor and improvement of quality of life were confirmed through follow-up for 2 months.