Back to Search
Start Over
Correlation between plasma ammonia level and serum trough concentration of free valproic acid in patients with epilepsy.
- Source :
-
Biological & pharmaceutical bulletin [Biol Pharm Bull] 2012; Vol. 35 (6), pp. 971-4. - Publication Year :
- 2012
-
Abstract
- Therapeutic drug monitoring of valproic acid (VPA) is essential to prevent toxicity, but the correlation between plasma ammonia level and serum VPA concentration remains unclear. We examined the correlation of plasma ammonia level with VPA dose and serum trough concentrations of total and free VPA in Japanese patients with epilepsy. Thirty-eight data sets from 19 Japanese patients with epilepsy were analyzed. The relations of VPA dose and serum total and free VPA concentrations with plasma ammonia level, and the breakpoints of VPA parameters predicting hyperammonemia (plasma ammonia higher than 60 µmol/L) were analyzed. A significant positive correlation was observed between plasma ammonia level and VPA dose (r(s)=0.56, p=0.00062), serum trough total VPA concentration (r(s)=0.55, p=0.00086) and serum trough free VPA concentration (r(s)=0.58, p=0.00041). The breakpoints predicting hyperammonemia were VPA dose of 30.4 mg/kg, serum trough total VPA concentration of 90.9 µg/mL, and serum trough free VPA concentration of 8.65 µg/mL, with impurity reductions at 1.35, 1.35 and 2.02, respectively. These findings suggest that serum trough concentration of free VPA is the most reliable predictor for hyperammonemia, and that the risk of developing hyperammonemia may increase in patients with serum trough free VPA concentrations higher than 8.65 µg/mL.
- Subjects :
- Adolescent
Adult
Anticonvulsants pharmacokinetics
Anticonvulsants therapeutic use
Asian People
Child
Child, Preschool
Epilepsy drug therapy
Female
Humans
Infant
Infant, Newborn
Male
Valproic Acid pharmacokinetics
Valproic Acid therapeutic use
Young Adult
Ammonia blood
Anticonvulsants blood
Epilepsy blood
Valproic Acid blood
Subjects
Details
- Language :
- English
- ISSN :
- 1347-5215
- Volume :
- 35
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Biological & pharmaceutical bulletin
- Publication Type :
- Academic Journal
- Accession number :
- 22687541
- Full Text :
- https://doi.org/10.1248/bpb.35.971