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The American Academy of Clinical Toxicology
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June 2, 2022

Question of the Day – Thursday, May 26, 2022

The use of valproic acid in critically ill patients can result in toxic encephalopathy due to elevated plasma concentrations of what compound?

The use of valproic acid (e.g., Depakote) in critically ill patients frequently results in elevated plasma concentrations of ammonia. The hyperammonemic encephalopathy associated with valproic acid can be treated with levocarnitine, lactulose, or a combination of the two.

Nicholson C, Fowler M, Mullen C, Cunningham B. Evaluation of levocarnitine, lactulose, and combination therapy for the treatment of valproic acid-induced hyperammonemia in critically ill patients. Epilepsy Res. 2021 Dec;178:106806. doi: 10.1016/j.eplepsyres.2021.106806. Epub 2021 Nov 2. PMID: 34763268.

Posted in Question Of The Day
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  • Education & Groups
    • American Board of Applied Toxicology (ABAT)
      • ABAT Exceptional Service Award
      • ABAT Newsletter
      • Sitting for the American Board of Applied Toxicology Exam
        • ABAT Examination Study Guide
      • Certification Renewal Documents
      • Life Long Learning Articles (LLSA)
      • ABAT Member Directory
        • Diplomate Verification
      • ABAT Board of Directors Contact Information
    • E-Learning
      • Advanced Hazmat Life Support Training
      • MMTI Fundamentals for Front-Line Practitioners Training
      • TOXISMO Society for the Discussion of Scientific Literature
      • ToxNow
      • Webinars
        • ABAT Journal Club Webinars
        • COVID Webinar Series
    • Toxicology Residency & Fellowship Training Programs
    • Clinical Toxicology Guidelines Collaborative
      • Recommendations
    • Fellows of AACT
    • ToxCoach Mentorship Program
    • Committees
    • Sections
      • Acute & Intensive Care
      • Addiction Toxicology Section
      • Clinical Toxicology In Sports
      • Diversity, Equity, and Inclusion Section
      • Herbs & Dietary Supplements
      • Geriatric Toxicology
      • Occupational / Environmental
      • Envenomations
      • Forensic
      • Pediatric
      • Weapons of Mass Destruction
      • Toxicology History
      • Radiation
      • Trainee and Student
    • Student Chapters
  • NACCT Annual Meeting
    • General Information Post-Conference
    • Sponsors
    • After the Fact CE
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