Welcome we are vulcoek acid and that is our generic name we have brand names of difficult cyano and bellevue to propel pentanoic acid is our chemical name allow me to discuss our drug classifications our therapeutic drug classification is anti-convulsant our pharmacologic drug classification is carboxylic acid derivative let us proceed to our pregnancy
Category our pregnancy category is category d women of childbearing potential should not be started in vulperic acid without neurological advice adequate counseling should be made available to all women with epilepsy of childbearing potential regarding the risk associated with pregnancy because of the potential trautogenic risk to the fetus now let’s talk
About our mechanism of action vulperic acid exhibits its pharmacological effects in a couple of ways such as by acting on e aminobutyric acid levels in the cns blocking voltage-gated ion channels and also by inhibiting histone the accetylase furthermore the mechanism by which evaporate exerts its anti-epileptic effects is not known however its anticonvulsant
Effect may be related at least in part to increase brain concentration of the inhibitory neurotransmitter e aminobutyric acid thank you partner for discussing those now let’s explore our pharmacokinetics first is our absorption we are rapidly absorbed from the gastrointestinal tract having a peak concentration attained after one to two hours we are distributed
Rapidly throughout the body with 80 to 95 protein binding and metabolized by the liver and is created in the urine thank you partner now let’s proceed to our indications and contraindications but first indications i am indicated to be used as a monotherapy or adjunctive therapy in the management of complex partial seizures and simple or complex absence seizures
I am also indicated for prophylaxis of migraine headaches acute management of mania associated with bipolar disorder my off-label uses include maintenance therapy for bipolar disorder treatment for acute bipolar depression and emergency treatment of status epilepticus next mycontra indications contra indicated in patients hypersensitive to drug use cautiously
In patients with history of hepatic dysfunction don’t give operate sodium injection to patients with hepatic disease significant hepatic dysfunction or acute head trauma hyper-ammonomic encephalopathy sometimes fatal has been reported following an initiation of a fluid therapy in patients with urea cycle disorder a group of uncommon genetic abnormalities and
Particularly ornithine transcarp amylase deficiency blockbox warning serious or fetal hepatic failure has been reported during the first six months of treatment patients below two years old is more in danger of hepatic toxicity there is an increased risk of fatality in anti-convulsant body therapy in older patients hepatotoxicity may present with symptoms
Of weakness lethargy anorexia facial edema vomiting and loss of seizure control monitoring symptoms and liver function tests at baseline and then frequently is recommended particularly during the first six months of treatment the use of vulproic acid in patients with mitochondrial disease has been demonstrated to increase the risk of hepatotoxicity and death
Vulproic acid should only be used in patients over two years old with suspected mitochondrial disorders who have failed to respond to other anticonvulsant treatments with frequent monitoring of liver function tests and dna polymerase subunit gamma mutation screening it can cause life-threatening pancreatitis cases of hemorrhagic pancreatitis with rapid progression
To death have been reported in all ages regardless of treatment duration if patients have symptoms of pancreatitis such as nausea vomiting abdominal pain or anorexia advise them to discontinue the medication and start alternative treatment based on clinical indication it can cause severe congenital malformations such as neural tube defects and lower iq scores
After in neutral exposure additionally in neutral exposure to vulcaric acid correlates with an increased risk of autism spectrum disorders in children the use of operoic acid in pregnant women for migraine headaches is contraindicated unless there is no other alternative anti-convulsant therapy according to apa guidelines additional screening is recommended
For women with bipolar disorder who choose to continue taking vaporic acid during pregnancy now for my side and adverse effect in the cardiovascular system we have chest pain and bleeding in the digestive system we have nausea vomiting diarrhea and hepatotoxicity in the endocrine system or lymphatic system we have drop in body temperature and anaphylaxis in
The muscular system we have muscle spasm in the nervous system we have headache psychosis stephen johnson syndrome hypothermia encephalopathy trauma and suicidal thoughts in the respiratory system we have rapid breathing in the skin we have feeling or blistering skin in the skeletal system we have weakness or swelling in the joints and reproductive system
We have polycystic ovarian syndrome when administering us to the patient here are some special considerations to be taken first thing is the nurse must evaluate patients with risk factors associated with ucd before initiation of while provide therapy second we should be administered with food to minimize gi irritation third is vaporic acid or us may cause
False positive test results for urinary ketones also we are reportedly outdoors thyroid function test results the next thing is the nurse must monitor plasma level and make dosage adjustment as needed therapeutic range of drug is 50 to 100 micrograms per milliliter and watch for tremors because they may indicate need for dosage reduction lastly the nurse must
Evaluate liver function platelet count and pt at baseline and monthly intervals especially during first six months of therapy that’s all thank you for listening you
Transcribed from video
Drugs That Modulate the Inhibitory
Neurotransmitter GABA: Valproic Acid by Nelmida and Bartolini By Batch Kunzite
