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Second and subsequent admissions were excluded to remove the bias of an individual susceptibility to a particular drug. From this group of valproate overdoses only a patient's first admission was included, all other admissions were excluded. The study cases included valproate overdose admissions between January 1991 and November 2001. The relative toxicity of valproate was also investigated using a comparison cohort of other poisoned patients over this 10-year period.

The cases occurred over a 10-year period, hence providing information on the epidemiology of valproate poisoning.

#ALLEN DATAGRAPH I THIRTY G SERIES#

We report the only single-centre series of valproate poisonings.

This is not supported in the two previous case series where complications such as coma with or without cerebral oedema, hypotension, pancytopaenia, metabolic acidosis and hyperammonaemia were rare. However, there is a multitude of case reports of severe toxicity, giving the impression that valproate has significant toxicity with a narrow therapeutic index. Дespite valproate being available for over 20 years there are only two large case series of valproate poisoning. This is likely to be a result of the broadening clinical uses of the drug, including its use as a mood stabilizer in patients with bipolar and affective disorders. Sodium valproate or valproic acid is becoming an increasingly common agent to be taken in overdose, with a sharp rise in incidence over the last 5 years. Although valproate prescriptions increased over the 10 years, there was relatively greater increase in the incidence of valproate poisoning. Comparison of valproate, carbamazepine, phenytoin and control groups showed that length of stay for both phenytoin and carbamazepine was significantly longer than for valproate ( P < 0.0001), and there was a significantly increased risk of intensive care unit admission for carbamazepine vs valproate (OR 2.73 95% CI 1.22, 6.28 P = 0.015). One patient had metabolic acidosis and thrombocytopaenia consistent with severe valproate toxicity. There was one death not directly related to valproate. In patients co-ingesting other medications, moderate to severe effects were consistent with the co-ingestants.

Of the 15 cases, drowsiness occurred in two patients (both taking>200 mg kg в€’1), vomiting occurred in four and tachycardia in five. It is recommended you use the Ctrl+F Find function and search for the cutter brand name, then look for the model below that.There were 79 patients with valproate poisoning from January 1991 to November 2001, 15 cases with valproate alone. If you do not have the latest version of Flexi, then this list may be inaccurate for you. Note that this list reflects what is currently in the latest version of Flexi. This is a complete and updated list of cutters compatible with Flexi and the Production Manager.

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