Concentrations Of Sodium Valproate Research Articles

Sodium valproate effects on the morphological and neurobehavioral phenotype of zebrafish

The anticonvulsant sodium valproate (SV) is frequently administered as a medicament but bears several negative effects in case of exposure during development. We analyzed extensively these early development effects of using the zebrafish model. Zebrafish embryos were exposed as eggs to two sublethal concentrations of SV, 10 and 25mg/L. A general embryo toxicity analysis revealed extended anomalies in the cardiovascular system, and in the craniofacial and the spinal skeleton, as well as high mortality, in the embryos exposed to SV. The teratogenic potential of SV was confirmed in hacthed larvae by morphometric and cartilage profile analysis. Last, neurobehavioral impairments due to SV were highlighted in subjects’ activity, anxiety, response to stimulations, habituation learning, and daily synchronization of locomotor activity, overall mirroring typical phenotypes associated with autistic spectrum disorders. In conclusion, our results confirmed the presence of extended and multifaced impacts of exposure to SV during development.

Development and Internal Validation of Machine Learning Algorithms for Determining Sodium Valproate Concentrations below the Standard Level Using a Risk Prediction Model of Children with Epilepsy

Background. There is a narrow therapeutic window for sodium valproate, and the blood concentration is too low to control epilepsy, while it is easy to poison the body if the concentration is too high. It is therefore necessary to monitor drug concentration reasonably in order to control epilepsy. The purpose of this study was to establish a model for predicting concentrations of sodium valproate below 50 μg/mL in children with epilepsy. Methods. The clinical data and biochemical examination results of children with epilepsy treated in the pediatric outpatient department of our hospital from June 2019 to March 2022 were retrospectively collected and divided into a development group and a validation group according to a patient ratio of 8 to 2. Five machine learning algorithms were used to identify the key variable factors, and a risk prediction model for sodium valproate blood concentrations lower than the standard concentration was established. The area under the curve (AUC), calibration curve, GiViTi calibration band, and clinical influence curve were used to evaluate the diagnostic efficacy and clinical application value of the model. Results. A total of 525 children with epilepsy were enrolled. In the development group, the random forest algorithm performed best in predicting that the blood concentration of sodium valproate was lower than the standard concentration, showing the highest AUC (1.00). Six factors were determined as a nomogram to predict the incidence of low concentrations. In the validation group and the development group, the calibration curve, GiViTi calibration band, and clinical influence curve all performed well in the evaluation of the diagnostic efficacy and clinical application value of the model. Conclusions. This finding highlights the importance of examining biochemical indices in patients when data regarding the blood concentration of sodium valproate are lacking.

A New Sensitive Fluorescence Sensor and Photocatalyst for Determination and Degradation of Sodium Valproate Using g-C3N4@Fe3O4@CuWO4 Nanocomposite and FCCD Optimization.

In this research, carbon nitride nanocomposite coupled with Fe3O4 and CuWO4 was thermally synthesized and characterized by different techniques, including SEM, TEM, XRD, EDX, and FTIR. Due to sodium valproate's luminescence quenching of this nanocomposite, a reliable, accurate, sensitive, selective, and fast-acting sodium valproate assay was proposed. Optimization of this fluorescent sensor was carried out by the FCCD approach. In the optimum conditions, the plot of sodium valproate concentration versus nanocomposite fluorescence emission showed a linear response (R2 = 0.9918), with a range of 0-0.55µM, the limit of detection (S/N = 3) equal to 0.85nM and limit of qualification equal to 2.82nM. Photocatalytic activity of g-C3N4@Fe3O4@CuWO4 (40%) nanocomposite exhibited a good potency to sodium valproate degradation. Active species of degradation including superoxide radicals, holes, and hydroxyl radicals were investigated using ammonium oxalate, benzoquinone, and 2-propanol to identify the mechanism of photodegradation action. The activity of benzoquinone in the photocatalytic process led to a reduction in the rate of analyte degradation, which indicates the prominent role of superoxide radicals compared to other species in the degradation process. The degradation rate of the analyte using the Fenton reagent was found to be around two times more than in the Fenton reagent-free process. The possible mechanism for the fluorescence sensor and photocatalytic degradation reaction was also discussed.

Sodium valproate exposure influences the expression of pparg in the zebrafish model.

Valproic acid (VPA) is an anti-epileptic drug used alone or in combination with other medications to treat seizures, mania, and bipolar disorder. VPA recognized as a teratogenic chemical can cause severe birth defects mainly affecting the brain and spinal cord when administered during pregnancy. However, the potential mechanisms of developmental toxicity are still less studied, and in the present study, the influence of VPA exposure was evaluated on zebrafish early-life stages. Zebrafish were exposed to two sublethal concentrations of sodium valproate (SV) (0.06 mM and 0.15 mM) from 24 hours post-fertilization (hpf) to 96 hpf and the SV teratogenic potential was investigated through morphometric analysis of zebrafish larvae combined with the evaluation of cartilage profile. Moreover, the effect of SV on the transcription level of pparg was also performed. The results of the study showed the teratogenic potential of SV, which disrupts the morphometric signature of the head and body. The marked distortion of cartilage structures was paralleled to a malformation of telencephalon and optic tectum in both concentrations suggesting a high teratogen effect of SV on the brain. These data were further confirmed by the increased expression of pparg in the zebrafish head. Overall, the present study confirms the teratogenic activity of SV in the zebrafish model and, for the first time, points out the potential protective role of pparg in the SV dose-dependent toxicity.

Impact of Intestinal Microbiota Disparities on Sodium Valproate Concentrations in Pediatric Epileptic Patients

Impact of Intestinal Microbiota Disparities on Sodium Valproate Concentrations in Pediatric Epileptic Patients

Ag Nanoislands Modified Carbon Fiber Nanostructure: A Versatile and Ultrasensitive Surface-Enhanced Raman Scattering Platform for Antiepileptic Drug Detection

A high-efficiency surface-enhanced Raman scattering (SERS) detection method with ultra-high sensitivity has been widely applied in drug component detection to optimize the product quality verification standards. Herein, a controllable strategy of sputtering Ag nanoislands on carbon fiber (C-fiber) via magnetron sputtering technology was proposed to fabricate a versatile Ag-C-fiber SERS active substrate. A wide range of multi-level electromagnetic enhancement “hot spots” distributed on Ag-C-fiber nanostructures can efficiently amplify Raman signals and the experimental enhancement factor (EEF) value was 3.871 × 106. Furthermore, substantial “hot spots” of large-scale distribution guaranteed the superior reproducibility of Raman signal with relative standard deviation (RSD) values less than 12.97%. Limit of detection (LOD) results indicated that when crystal violet (CV) is employed as probe molecule, the LOD was located at 1 × 10−13 M. By virtue of ultra-sensitivity and good flexibility of the Ag-C-fiber nanotemplate, Raman signals of two kinds of antiepileptic drugs called levetiracetam and sodium valproate were successfully obtained using an SERS-based spectral method. The Ag-C-fiber SERS detection platform demonstrated a good linear response (R2 = 0.97486) in sensing sodium valproate concentrations in the range of 1 × 103 ng/μL−1–1 ng/μL. We believe that this reliable strategy has potential application for trace detection and rapid screening of antiepileptic drugs in the clinic.

Effects of concurrent and staggered dosing of semi-solid enteral nutrients on pharmacokinetic behavior of antiepileptic drugs after oral administration in rats.

BackgroundThe use of enteral nutrients plays a highly important role in accurate nutrition management, but limited information is currently available on the cautionary points of semi-solid enteral nutrients.AimIn this study, we examined whether the pharmacokinetic profiles of sodium valproate (SVA), levetiracetam (LEV), and carbamazepine (CBZ) are affected by altering the dosing time of RACOL®-NF Semi Solid for Enteral Use (RASS), a prescribed semi-solid formula. We also investigated whether the pharmacokinetic interaction observed in this study can be avoided by staggered dosing of the chemical drug and semi-solid enteral nutrient.MethodsThe plasma concentration of SVA, LEV and CBZ after oral administration was measured by LC-MS/MS method.ResultsThere was no difference in pharmacokinetic characteristics of SVA and LEV when the dosing time of RASS was altered. On the other hand, the plasma concentration of CBZ after oral administration at all sampling points decreased with the extension of the dosing time of RASS, which was consistent with the Cmax and AUC. However, no significant difference was observed in the pharmacokinetic profiles or parameters of CBZ between the short-term and long-term RASS dosing groups by prolonging the administered interval of CBZ and RASS for 2 hr.ConclusionWe concluded that the pharmacokinetic profiles of CBZ, but not SVA and LEV, after its oral administration are affected by the dosing time of RASS, but staggered administration of CBZ and RASS prevented their interaction.

Factors Influencing Sodium Valproate Serum Concentrations in Patients with Epilepsy Based on Logistic Regression Analysis

BackgroundWe aimed to explore the risk factors that affect the serum concentration of sodium valproate (VPA-Na) in patients with epilepsy and to provide references for the rationale of the use of VPA-Na.Material/MethodsThe enzyme-multiplied immunoassay technique was used to determine the serum VPA-NA concentrations of 109 patients, and the results were retrospectively analyzed and summarized. A multivariate logistic regression model was used to analyze substandard serum VPA-Na concentrations.ResultsFifty-six patients (51.38%) treated with VPA-Na tablets were within the effective treatment range of 50–100 μg/mL, while 53 patients (48.62%) were out of the treatment range. The results indicated that the standard-reaching rate of serum drug concentration in the juvenile group was higher than that in the adult and elderly groups; the standard-reaching rates of serum drug concentrations in the low-dose group and the intermediate-dose group were lower than that in the high-dose group; and the standard-reaching rate of serum drug concentration in the group receiving carbapenems in combination was lower than that in the non-combination group; all differences were statistically significant. The combination with carbapenems and enzyme inducers was an independent risk factor for VPA-Na serum concentration below the target level in hospitalized patients.ConclusionsTo improve clinical efficacy and reduce the occurrence of adverse reactions, there is a need for therapeutic drug monitoring of VPA-Na. Moreover, individual administration should be implemented when VPA-Na tablets are used in the treatment of epilepsy because of the significant fluctuation in VPA-Na blood concentration.

Ventriculoperitoneal shunt malfunction diagnosis based on substance dilution.

Objective:Current methods for the diagnosis of ventriculoperitoneal (VP) shunt malfunction lack specific standards; therefore, it may be missed or misdiagnosed. Hence, providing a reliable diagnostic method will help improve the accuracy of preoperative decision-making. Therefore, the aim of the study was to provide a new method for the diagnosis of VP shunt malfunction.Methods:After in vitro testing, we enrolled a total of 12 patients with VP shunt malfunction. Before revision surgery, 0.1 mL of a 5% sodium valproate (SV) solution was injected into the reservoir; 0.1 mL of the cerebrospinal fluid (CSF) was withdrawn 20 minutes later from the reservoir to measure the SV concentration. The process was repeated on the seventh day after surgery and compared with the preoperative results.Results:The mean ± standard deviation preoperative SV concentration in the cerebrospinal fluid was greater than the postoperative concentration (5967.8 ± 1281.3 vs 391.1 ± 184.6 μg/mL, P = .001).Conclusion:The proposed method is a reliable, safe, and relatively simple alternative for the diagnosis of VP shunt malfunction and further provides a reference for treatment.

UGT1A6 and UGT2B7 Gene Polymorphism and its Effect in Pediatric Epileptic Patients on Sodium Valproate Monotherapy

To evaluate the pattern of UGT1A6 and UGT2B7 gene polymorphism in pediatric epileptic patients and to compare the sodium valproate concentration in different patterns of UGT gene polymorphism. In this cross-sectional study, 99 pediatric epileptic patients aged 2-18 y receiving Sodium valproate monotherapy for the past one month were included from JusticeK S Hegde Charitable hospital, Mangalore after obtaining informed consent. Genetic polymorphism patterns were evaluated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Trough level serum valproate concentration was estimated by high-performance liquid chromatography (HPLC). Sodium valproate concentration in different UGT genotypes was compared by Analysis of Variance (ANOVA). P value <0.05 was considered significant. In the present study population, the predominant mutant allele pattern was observed in UGT1A6 (T19G, A541G, A552C) gene. In UGT2B7 (A268G, C161T) showed predominant mutant allele pattern while (G211T) showed predominant wild type. Mean steady-state sodium valproate concentration was 105.40 ± 49.9μg/ml and adjusted sodium valproate concentration was 5.5± 3.2mg/kg/L. It was found that there was no statistical difference in sodium valproate concentration in different UGT1A6 and UGT2B7 gene polymorphism. The present study concluded that though there was a difference in pattern of gene polymorphism with concerning UGT1A6 and UGT2B7, however, it has not contributed to variation in serum concentration of sodium valproate in the present study population.

Effects of atorvastatin and aspirin on post-stroke epilepsy and usage of levetiracetam.

Objective:Atorvastatin and aspirin have been used in treating different forms of epilepsy. However, their effect on post-stroke epilepsy (PSE) still needs to be validated by large-scale clinical studies. In addition, their impact on the use of the antiepileptic drug levetiracetam for post-stroke epilepsy remains to be explored. Thus, the aim of this study was to further evaluate the effect of atorvastatin and aspirin on PSE and their effect on the usage of the antiepileptic drug levetiracetam in PSE patients.Methods:Patients, aged 65 to 85 years, with newly diagnosed post-ischemic stroke epilepsy from August 30, 2014 to August 30, 2018 were included in the study, with the exclusion of those with coexisting conditions.Results:Initially, 1321 patients were included, and 780 remained in the study at the 1-year follow-up. During the study, atorvastatin treatment with or without aspirin reduced the number of clinical epileptic episodes in PSE patients. It also reduced the dosage of levetiracetam and achieved better control of epilepsy compared to levetiracetam mono-treatment. Aspirin co-treatment with levetiracetam did not result in a significant improvement. However, the combination of aspirin with atorvastatin significantly reduced the number of seizures compared to atorvastatin treatment alone.Conclusion:Atorvastatin and aspirin co-treatment with levetiracetam can reduce epilepsy in PSE patients and reduce the dosage of levetiracetam required for effective control of PSE.

Investigations on the pH-dependent binding of sodium valproate with bovine serum albumin: A calorimetric, spectroscopic and volumetric approach

The present study reports the binding behaviour of sodium valproate (SV) with bovine serum albumin (BSA) at different temperatures and pH (5.8, 7.4 and 8.0) of the medium using calorimetry, spectroscopy (UV–visible absorption, 1H NMR) and volumetry (density and sound velocity). Calorimetric results indicate the involvement of electrostatic, hydrogen bonding and van der Waals interactions in the binding process. The decrease in binding constant (K) and increase in the burial of hydrophobic groups of BSA upon SV binding has been observed from calorimetry with increase in pH from 5.8 to 8.0. The absorption measurements revealed the formation of ground state complex with 1:1 stoichiometry of binding as well as no change in the microenvironment around the amino acid residues of BSA after binding with SV. The broadening of the 1H NMR signals of the protons of SV upon binding with BSA has also been observed. The larger polar interactions/dehydration phenomenon at lower whereas non-polar interactions/ hydrational phenomenon at higher SV concentrations for SV-BSA binding have been noticed from the variation of trends of V, E°, and Ks values with drug concentrations as well as with temperature at all the studied pH values of the medium.

Factors Influencing Plasma Concentrations of Phenytoin, Phenobarbitone, Carbamazepine and Sodium Valproate in Epileptic Patients Attending a Tertiary Care Hospital

Objective: The traditional anti-epileptic drugs like phenytoin, sodium valproate and carbamazepine continue to be used widely in the low to middle income countries due to their time tested efficacy and low costs. The factors which affect the AED concentrations in non-toxicity indications has not been reported so far. Hence, we studied the factors that could influence the plasma concentrations of these AEDs. Methods: This is a retrospective record based study and a short term prosepective study. Requisition forms of epileptic patients referred for TDM 2012-2014 were compared with the AED concentrations reported. Epileptic patients who were referred during May-June 2015 for TDM were evaluated for their seizure history and anthropometic measurements for calculation of extracellular volume (VECW) and compared with the AED concentrations. Results: Out of the 170 requisitions for TDM, 68.2% were monotherapy and 31.8% received two or more antiepileptic drugs. In 44% of patients, the plasma concentrations of the AED correlated with clinical response. In our study the plasma level of carbamazepine was found to be reduced by phenytoin, sodium valproate concentration was reduced by carbamazepine and phenytoin levels were reduced by sodium valproate. In male, phenytoin levels were significantly lower than in female, Phenytoin decreased carbamazepine levels significantly in female. Carbamazepine significantly decreased sodium valproate concentrations in females. Carbamazepine dose adjusted for weight and VECW was found to show a trend of correlation to the blood levels, Conclusion: TDM for AEDs is an indispensable investigation that guides the clinicians to tailor dose of drugs in individual patients. Factors such as age, gender, concomitant drugs in general and VECW in patients on carbamazepine needs to be considered while interpreting AED plasma concentrations for monitoring therapy.

Sodium valproate suppresses abnormal neurogenesis induced by convulsive status epilepticus.

Status epilepticus has been shown to activate the proliferation of neural stem cells in the hippocampus of the brain, while also causing a large amount of neuronal death, especially in the subgranular zone of the dentate gyrus and the subventricular zone. Simultaneously, proliferating stem cells tend to migrate to areas with obvious damage. Our previous studies have clearly confirmed the effect of sodium valproate on cognitive function in rats with convulsive status epilepticus. However, whether neurogenesis can play a role in the antiepileptic effect of sodium valproate remains unknown. A model of convulsive status epilepticus was established in Wistar rats by intraperitoneal injection of 3 mEq/kg lithium chloride, and intraperitoneal injection of pilocarpine 40 mg/kg after 18-20 hours. Sodium valproate (100, 200, 300, 400, 500, or 600 mg/kg) was intragastrically administered six times every day (4-hour intervals) for 5 days. To determine the best dosage, sodium valproate concentration was measured from the plasma. The effective concentration of sodium valproate in the plasma of the rats that received the 300-mg/kg intervention was 82.26 ± 11.23 μg/mL. Thus, 300 mg/kg was subsequently used as the intervention concentration of sodium valproate. The following changes were seen: Recording excitatory postsynaptic potentials in the CA1 region revealed high-frequency stimulation-induced long-term potentiation. Immunohistochemical staining for BrdU-positive cells in the brain revealed that sodium valproate intervention markedly increased the success rate and the duration of induced long-term potentiation in rats with convulsive status epilepticus. The intervention also reduced the number of newborn neurons in the subgranular area of the hippocampus and subventricular zone and inhibited the migration of newborn neurons to the dentate gyrus. These results indicate that sodium valproate can effectively inhibit the abnormal proliferation and migration of neural stem cells and newborn neurons after convulsive status epilepticus, and improve learning and memory ability.

COMPARISION OF LOCAL ANAESTHETIC POTENTIALS OF DRUGS HAVING MEMBRANE STABILIZING EFFECT ON INFILTRATION ANAESTHESIA IN GUINEA PIGS

Objective : To compare the local anaesthetic action of central neuron sodium channel blockers Phenytoin Sodium, Sodium Valproate and Carbamazepine with peripheral neuron sodium channel blockers Lignocaine using Infiltration anaesthesia in guinea pigs Material and Methods: In the present study,the local anaesthetic effect of Lignocaine with concentration of 0.2%, 0.1% ,0.05% was compared with Phenytoin Sodium, Sodium Valproate and Carbamazepine in concentrations of 0.2%, 0.1% ,0.05% using different dilutions of 0.05N,0.1N,0.2N HCL in guinea pig by pricking on the skin produces a squeak or movement indicating pain is produced. Results : The results of our present study suggest onset of local anaesthesia with lignocaine 0.2% is significantly fast when compared with concentration of 0.1%, and 0.05% indicating it has better efficacy when using for various  local anaesthetic procedures. In addition onset of local anaesthesia with Phenytoin sodium concentrations of 0.2%, 0.1% ,0.05%  is fast  when compared with Sodium valproate concentrations of 0.2%, 0.1% ,0.05%  and Carbamazepine concentrations 0.2%, 0.1% ,0.05%. Conclusion: Among antiepileptic drugs with local anaesthesia and  membrane stabilizing activity Phenytoin sodium showed fast on set of action when compared with sodium valproate and Carbamazepine indicating it has better efficacy. Keywords : Local Anaesthetics, Membrane Stabilizing, Infiltration anaesthesia.

Effects of Sodium Valproate on the Growth of Human Ovarian Cancer Cell Line HO8910

To explore a possible new treatment for human ovarian cancer, we studied the effects of sodium valproate on the growth of the HO8910 human cell line. HO8910 cells were cultured in vitro and treated with different concentrations of sodium valproate. Cell proliferation, cell cycling, and apoptosis were measured by flow cytometry, cell morphology under a microscope, and expression levels of WWOX and P27 by Western blotting and RT-PCR. Tumor xenografts were established to determine in vivo effects of sodium valproate. Our results showed that cell proliferation was decreased with increasing concentration of sodium valproate, with features of cytoplasmic retraction and floating cells. Moreover, cell cycle analysis revealed a higher apoptosis rate and G0/ G1 phase in the sodium valproate experimental group than in the control group. In addition, protein expression levels of WWOX and P27 were elevated. Importantly, sodium valproate decreased in vivo xenograft tumor burden and up-regulated WWOX and P27 expression in nude mice. In conclusion, sodium valproate might play a role in inhibition and control of ovarian cancer cell line HO8910 by inhibiting cell proliferation, interfering with the cell cycle and promoting apoptosis, so that it may be effective in the clinical treatment of ovarian cancer.

Analysis of related factors between the serum concentrations of sodium valproate and its effectiveness

Objective: To analyze the influencial factors of serum concentrations of sodium valproate in epilepsy patients,so as to provide reference for rational use of sodium valproate.Methods: Serum concentrations of sodium valproate were determined by enzyme-enhancement immunoassay technique.The relationships of serum concentrations of sodium valproate,age and gender of patients,therapeutic effectiveness and dosages were analyzed.Results: In the 158 cases,the concentrations of sodium valproate which were 50,50-100,100 μg/ml accounted for 69(43.67%),70(44.30%),19(12.03%) and the total effective rates were 36.32%,87.14%,78.94%,respectively.The effectiveness were significantly different among different serum concentration groups(50,50-100,100 μg/ml),and different dose groups(400,400-800,800 mg/d).There was no statistical difference between male and female patients,or among different age groups.Conclusion: It is necessary to make out individual therapeutic regimens of sodium valproate according to results of serum concentration monitoring.

Effects of valproic acid (VPA) and levetiracetam (LEV) on proliferation, apoptosis and hormone secretion of the human choriocarcinoma BeWo cell line

AbstractEpilepsy has been associated with poor obstetric outcomes that may be the result of the epilepsy or a direct effect of anti-epileptic drugs on placentation. To investigate any direct effect of anti-epileptic drugs on cell proliferation, apoptosis and hormone secretion with focus on human chorionic gonadotropin (β-hCG), progesterone (P4) and 17β-estradiol (E2), BeWo cell line was cultured in the presence of different concentrations of sodium valproate (0.45, 0.6, 1.5 or 2mM) or levetiracetam (0.07, 0.12, 0.3 or 0.5mM) with appropriate solvent controls. Cell proliferation was measured using BrdU incorporation. Caspase-3 activity was used as a marker of cell apoptosis and was evaluated by a fluorometric assay. Additionally, hormone secretion was evaluated by ELISA kits. Dose-dependent action of VPA on cell proliferation occurred in parallel to stimulation of caspase-3 activity. LEV had no effect on cell proliferation, and after long term exposure to the drug, a decrease in caspase-3 activity was observed. A significant decrease in β-hCG, P4 and E2 production was observed when the cells were treated with VPA. LEV decreased β-hCG and E2 secretion but had no effect on P4 level. Direct inhibition of cell proliferation and hormone secretion along with apoptotic action suggest that exposure to VPA at therapeutic doses during early pregnancy should be approached with caution. Trophoblast cells appear to be less sensitive to LEV; however, further studies involving placental tissue are necessary to determine the safety of the drug.

Retrospective analysis of serum drug concentration monitoring in the Tenth People’s Hospital affiliated to Tongji University from 2003 to 2009

Objective:To summarize the results of serum drug concentration monitoring in the Tenth People's Hospital affiliated to Tongji University from 2003 to 2009.Methods:Serum concentrations of sodium valproate(255 cases),phenytoin sodium(33 cases),carbamazepine(48 cases) and digoxin(141 cases) were determined by immune fluorescence polarization method and the results were statistically analyzed.Results:Sodium valproate was the most frequently monitored drug among the three antiepileptic drugs,which accounted for 75.89%,while phenytoin sodium was the least.Serum concentration of carbamazepine of thirty-five cases was within the normal range,accounting for 72.92%(35/48),which was the highest among the three antiepileptic drugs.Serum concentration of digoxin of 114 cases was within the normal range,accounting for 80.85%(114/141).Conclusion:Serum drug concentration monitoring plays an important role in clinic.Its significance should be interpreted in conjunction with clinical manifestation.

Side effects of sodium valproate during long-term treatment in epilepsy

Side effects of sodium valproate during long-term treatment have been evaluated retrospectively in 55 patients suffering from refactory epilepsy. The side effects discovered in the study were slight and transient. In three of the 55 patients CNS side effects were noticed. Gastrointestinal symptoms were uncommon. One patient suffered from loss of hair which could have been attributed to sodium valproate. Severe side effects such as abnormal blood counts or organ damage were not discovered. The frequency of side effects was similar to those already reported in the literature except for gastrointestinal symptoms which were more infrequent than previously reported. No direct correlation could be established between the serum concentration of sodium valproate and the side effects.