title: Disposition of valproic acid in self-poisoned adults.
abstract: Acute intoxication with valproic acid is increasingly being observed in clinical practice. In Poland, such intoxication frequently occurs as a result of mixing different drugs or alcohol. We studied the pharmacokinetics of valproic acid in five intoxicated patients. Apart from valproic acid, barbiturates, chlorprotixene, tricyclic antidepressants, tetrahydrocannabinols and alcohol were detected and measured. The absorption of the drug was rapid and the maximum concentration was observed after the period of 3.5-5.6 hr. The lowering of the valproic acid level in plasma was biphasic, with terminal half-life ranging between 8.8-30.9 hr. The calculated apparent volume of distribution was 0.17-0.72 l/kg and could be affected by varied levels of doses as well as time of drug intake (data from interviews of patients) used for calculation and reduction in plasma protein binding at higher concentration of valproic acid. Frequent multiple drug poisonings oblige toxicological laboratories not only to monitor valproic acid concentration in serum, but also to perform the toxicological screenings.
authors.affiliation: Department of Analytical Toxicology and Therapeutic Drug Monitoring, Collegium Medicum, Jagiellonian University, Krakow, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Wilimowska
authors.forename: Ewa
authors.initials: E
authors.lastname: Florek
authors.forename: Wojciech
authors.initials: W
authors.lastname: Piekoszewski
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000097:blood / Q000493:pharmacokinetics* / Q000506:poisoning*; D001798:Blood Proteins / Q000378:metabolism; D003128:Coma / Q000139:chemically induced; D004347:Drug Interactions; D005260:Female; D016231:Fluorescence Polarization Immunoassay; D015600:Glasgow Coma Scale; D006207:Half-Life; D006801:Humans; D007124:Immunoenzyme Techniques; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D011485:Protein Binding; D013406:Suicide, Attempted; D014635:Valproic Acid / Q000097:blood / Q000493:pharmacokinetics* / Q000506:poisoning*
chemical_list: D000927:Anticonvulsants; D001798:Blood Proteins; D014635:Valproic Acid