Activated charcoal PO x1 or multidose activated charcoal (for delayed-release preparations)
Increases valproate metabolism and recommended for patients with:
Lethargy, coma, VPA associated hyperammonemic encephalopathy, hepatic dysfunction
100mg/kg IV bolus, followed by 50mg/kg Q8h or alternatively 50mg/kg/day IV in 3 divided doses
Lethargy, coma, VPA associated hyperammonemic encephalopathy, hepatic dysfunction
100mg/kg IV bolus, followed by 50mg/kg Q8h or alternatively 50mg/kg/day IV in 3 divided doses
May be effective in reversing CNS depression by unclear mechanism
Effective but reserved for severe overdoses (VPA level >500 mcg/mL) and refractory hemodynamic instability and metabolic<unk> osis that do not respond to fluid resuscitation
Valproic acid toxicity
Tianeptine toxicity
Carbamate toxicity
Lithium toxicity
Benzodiazepine toxicity
Phenytoin toxicity
Antipsychotic toxicity
Carbamazepine toxicity