Valproic acid poisoning is fortunately uncommon. However, this is a potentially lethal and rather complex intoxication. Management spans the gamut from decontamination and dialysis, to various metabolic manipulations. With an aggressive and organized approach, most patients will do extremely well.
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Besides of valproic acid level, What lab should you order in a patient with new onset altered mental status who is taking Valproate? Ding…..Ding……Ding ….an ammonia level…. This is perhaps one of my favorite teaching points for residents. Followed by what do u give if ammonia is elevated, no cirrhosis history, and they are on valproate…..but L- Carnitine of course. However, if somebody is altered on Depakote order an ammonia level and a valproic acid level together. Do not wait and then reflexively ordered the ammonia level if the valproic acid level.elevated.in a patient on valproic acid with altered mental… Read more »