title: Population pharmacokinetic modelling of valproic acid and its selected metabolites in acute VPA poisoning.
abstract: BACKGROUND
  Valproic acid (VPA) is a first-line antiepileptic drug. It is used in the treatment of many different types of partial and generalized epileptic seizures. Though the clinical pharmacokinetics of VPA has been well defined, information about pharmacokinetics after overdoses is rare. The aim of this study was to try to build a population pharmacokinetic model that would describe the time course of VPA and its selected metabolites when the drug is ingested in an overdose situation.
  
  
  METHODS
  Blood samples were collected during admission to the hospital and several times during treatment for poisoning (10 men and 10 women). The concentration of VPA and its metabolites were determined by liquid chromatography coupled with mass spectrometry. For population pharmacokinetic evaluation of VPA and its metabolites, the two-compartment-model was applied.
  
  
  RESULTS
  The estimated doses of VPA taken ranged from 6 to 65g, while the time after ingestion ranged from 1 to 30h. Results showed that the β-oxidation process exhibited Michaelis-Menten kinetics becoming saturated during acute intoxication. The same could not be said for the desaturation route. VPA therapy increased the Vmax for β-oxidation by 59% while decontamination appeared to be of moderate efficacy lowering the F value by 34% on the average.
  
  
  CONCLUSIONS
  None of the models perfectly described the experimental data. Important factors like the variable degree of protein binding by VPA could not be included in the models. The small number of subjects used in the study made the analysis of more covariates impossible.
authors.affiliation: Department of Pharmaceutical Biophysics, Jagiellonian University, Kraków, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jawień
authors.affiliation: Department of Diagnostics, University Hospital in Krakow, Kraków, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Wilimowska
authors.affiliation: Chair and Department of Forensic Medicine, Jagiellonian University, Kraków, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kłys
authors.affiliation: Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Kraków, Poland; School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia. Electronic address: wpiekosz@tlen.pl.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Piekoszewski
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000378:metabolism* / Q000494:pharmacology*; D062787:Drug Overdose / Q000378:metabolism*; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction / Q000187:drug effects; D014635:Valproic Acid / Q000378:metabolism* / Q000493:pharmacokinetics*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
keywords: Acute poisoning; Metabolic pathway; Monolix; Population pharmacokinetics; Valproic acid