The patient from Toxicology Conundrum 055 with a massive valproate overdose arrives in the ICU, can you manage things from here?
A man presents with decreased level of consciousness following a probable ingestion of 96g of sodium valproate. Can you handle this toxicological emergency?
Valproic acid (sodium valproate) in overdose results in CNS depression and large overdoses can result in multi-system organ failure and death. Chronic toxicity can cause life threatening hyperammonia and hepatotoxicity.
Sodium valproate is a commonly used anti-epileptic drug, that come sin standard and enteric coated forms. Toxicity is characterised by metabolic failure, resulting in multi-organ dysfunction and cerebral edema
Sodium Valproate: anticonvulsant; decreasing neuronal excitability or enhancing inhibition of neuronal transmission.