Valproate Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 11 April 2019

⏱️ 15 minutes

🔗️ Recording | iTunes | RSS

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Summary

Valproate (valproic acid, Depakote) has numerous uses which includes migraines, seizures, and bipolar disorder.

In a patient who is taking valproate, it is important to monitor for signs and symptoms of confusion as this drug can cause elevated ammonia levels.

When switching between dosage forms of valproate, you must recognize that the bioavailability is not the same between each different dosage form. This could lead to toxicity or treatment failure.

Valproic acid has a boxed warning for hepatotoxicity and liver function needs to be monitored.

Valproic acid can increase lamotrigine levels which ultimately could lead to an increased risk of lamotrigine induced SJS.

Transcript

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0:00.0	Hey all, this is Eric Christensen Pharmacist back with you today on the Real Life Pharmacology podcast.
0:06.8	Thank you to all of you who have certainly followed the podcast, and hopefully you're listening and learning and picking up a few pearls.
0:14.9	If you like the podcast, like what you're here today, would love a kind rating and review on iTunes if you have the time or wherever
0:21.9	you're listening. Those have been greatly appreciated to those of you who have done that.
0:27.7	But with that note, let's get into it. Today I've got Depakote, which is the brand name or
0:35.1	Valproic acid or Valproate, it's sometimes called as the generic name there.
0:41.0	And this medication has quite a few potential uses.
0:46.1	It's one of those kind of jack-of-all-trades type medications,
0:49.9	but also has a lot of potential downsides, adverse effects, and those type of things, too.
0:56.5	Being one of those drugs with kind of multiple effects, you can anticipate that it's probably got a few different mechanism of action.
1:05.0	And the two major ones I'm going to talk about is it's got an effect as far as increasing the availability,
1:15.9	the effect of GABA, which if you remember in physiology, GABA is an inhibitory
1:24.1	neurotransmitter. So that's one effect, kind of increasing that activity,
1:28.6	availability. The other effect is its potential to block sodium channels, specifically
1:37.1	voltage gated sodium channels in the central nervous system. So they're by stopping the action potentials and different pathways
1:47.0	through that aspect there. So that kind of leads into some of the potential uses. And
1:56.2	classically, Depakot, or Valproic acid is classified as an anti-seizure medication, but it is definitely used in migraine prevention and also bipolar disorder.
2:09.4	There's a few other oddball uses that you may see it for from time to time, but those are really the big three that I see it used in clinical practice.
2:19.9	So seizures, migraines, and bipolar disorder.
2:24.3	Now getting into some of those effects, let's talk about the adverse effect profile
2:29.9	because there are definitely some very notable adverse effects.
2:35.8	For more of a generalized short-term type effect, I think of CNS changes.
	...

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