Any disorders of the functioning of the central nervous system require close attention to themselves. To combat this kind of problems, a lot of medicines have been developed with different principles of influencing the brain. One of them is Sodium Valproate.
Main components and release form
The main active ingredient of the drug - the sodium s alt of valproic acid - is a finely crystalline powder of white color, odorless. This is the form of release of the drug "Sodium valproate". Formula - С8Н15NAO2. Easily soluble in alcohol and water.
It is offered to the consumer in tablets and plastic double-layer bags. The minimum possible volume in one package is 0.5 kg. Next in ascending order: 1, 2, 5, 10, 20, 25, 30, 40, 50, 65 kg.
Pharmacodynamics
An antiepileptic drug is the main function of the drug "Sodium valproate". The mechanism of action is presumably based on an increase in the level of GABA (an amino acid, which is the most important inhibitoryneurotransmitter of humans and other mammals) in the CNS by inhibiting GABA transaminase and reducing the reuptake of this substance in the brain tissues. The consequence of this process, apparently, is a decrease in the excitability and predisposition of the motor areas of the brain to the development of seizures.
Sodium valproate can have a tranquilizing effect, reduce the feeling of fear, improve the mood of patients, their mental state. In addition, it demonstrates an antiarrhythmic effect. The drug is highly effective in absences (a symptom of epilepsy, one of the types of epileptic seizures) and temporal pseudo-absences, but has virtually no effect on the condition of patients with the development of psychomotor seizures.
Medicine sphere of influence
The main field of application of the drug "Sodium valproate" instructions for use regulates epilepsy, both in the form of monotherapy and in a combined treatment option. The drug is used in the presence of generalized seizures (polymorphic, large convulsive, etc.), partial and focal (motor, psychomotor, etc.). In addition, the drug is prescribed for convulsive syndrome, which often accompanies organic diseases of the human nervous system, behavioral disorders, as a rule, going hand in hand with epilepsy, with febrile convulsions and nervous tics in pediatric patients.
Sodium valproate instruction recommends for admission to patients suffering from manic-depressive psychosis withbipolar course in cases where the disease is not treatable with lithium and other medications.
Who is the drug contraindicated for?
Complex drugs such as antiepileptic drugs always have a certain list of contraindications for their use. You can not take the remedy for those who are hypersensitive to a substance such as valproic acid (sodium valproate, in fact, consists of its sodium s alt). The reason for refusing to use is the presence of functional abnormalities in the liver and / or pancreas in patients. Separately, it is worth highlighting hepatitis in this group of diseases (any form - acute, chronic, medicinal, etc., including in the anamnesis of family members).
Do not prescribe this drug for hemorrhagic diathesis, porphyria (in almost 99% of cases, a hereditary deviation, manifested in a violation of pigment metabolism with a high content of porphyrins in the blood and tissues).
Sodium valproate and pregnancy
The use of the drug in the first trimester of pregnancy is contraindicated. In the second and third trimester, the doctor will write a prescription for the purchase of sodium valproate medication only if the expected effect for the mother outweighs the potential risk for the child.
Patients should be advised that valproic acid can provoke the development of a number of congenital anomalies in the fetus. In addition, this substance is excreted in breast milk (concentrations can reach 10% of the amount contained in the mother's blood plasma). Therefore, breastfeeding during therapy with medicines containing valproic acid is permissible only in cases of emergency.
As a universal recommendation for women of reproductive age, there will be the use of reliable means or methods of contraception.
Unwanted effects
For patients undergoing treatment with sodium valproate, the instructions for use contain information about possible side effects from different systems and organs.
Possible CNS reactions include tremors, mood changes, behavioral changes, incoordination, drowsiness, dizziness and headaches, irritability, restlessness and unusual arousal.
Probable reactions of the gastrointestinal tract - loss of appetite, dyspepsia, nausea, vomiting, diarrhea, small cramps in the intestines or stomach. It is rare to hear about constipation or pancreatitis. In women, menstrual irregularities are possible. Often there are fluctuations in weight in one direction or another. The coagulation system may respond with thrombocytopenia, an increase in the amount of time it takes to stop bleeding. Possible dermatological abnormalities in the form of alopecia (pathological hair loss), allergic - in the form of a rash on the skin.
Drug regimen
The dosage regimen for each patient is strictly individual."Sodium valproate", the release form of which is in the form of a powder, is prescribed depending on body weight. The initial dosage for adult patients and children weighing more than 25 kg is 10-15 mg per kilogram of body weight (daily volume). If no side effects are observed, gradually (every 3-4 days) the dosage can be increased by 200 mg / day. until a noticeable clinical result is obtained. On average, the daily dosage can reach up to 30 mg / kg.
Medicine treatment regimen - 2-3 times a day with meals.
It is also practiced to prescribe sodium valproate intravenously (the allowable amount of the drug is 400-800 mg) or drip (25 mg / kg over a period of 24, 36, 48 hours).
The maximum possible dose for therapy in adult patients and children with a body weight of more than 25 kg is 50 mg / kg per day. If for some reason it is necessary to increase it (the dose), monitoring the concentration of valproate in the blood plasma is a prerequisite. If this indicator is more than 200 mg / l, the dosage should be reduced.
Overdosing
If, for any reason, the permissible dose of the drug "Sodium valproate" was exceeded (the prescription in Latin is not accessible to all patients), a number of unambiguous symptoms are observed. The most common reactions are impaired coordination of movements and balance, lethargy, myasthenia gravis (pathologically fatigued), hyporeflexia, nystagmus (involuntary fluctuations of the eyes with a high frequency),miosis (pupil constriction), heart block, coma.
Treatment is carried out in a hospital and consists of gastric lavage (it will be effective if taken enterally no later than 10-12 hours), providing osmotic diuresis (a large volume of urine with a high concentration of active osmotic components) and supporting the vital functions of the body. Hemodialysis will give a good effect.
Interaction with other substances
When used in parallel with other antipsychotics, antidepressants, MAO inhibitors, various derivatives of ethanol and sodium benzodiazepine, valproate will increase the inhibitory effect on the central nervous system. The combined use of the drug with hepatotoxic drugs, antiplatelet agents, anticoagulants may provoke an increase in the effect of these substances.
Concomitant use of valproic acid and phenobarbital will lead to the displacement of the latter from its association with plasma proteins. The consequence is an increase in its (phenobarbital) concentration in the blood plasma.
In general, sodium valproate can interact with a number of medications, so the patient should be notified about the possible (or unacceptable) parallel administration of it with other drugs by the attending doctor.
Special Instructions
With great caution, the drug is prescribed to patients suffering from diseases of the liver and pancreas (or having a history of them), children under the age of 3 years (the risk of developing hepatotoxicity is maximum, but withdecreases with age). It must be borne in mind that the likelihood of negative effects from the liver increases with combined anticonvulsant therapy.
Patients taking "Sodium Valproate" and having pathological changes in the blood should be very attentive to their state of he alth. Organic brain diseases, abnormalities in the functioning of the kidneys, hypoproteinemia are also quite serious risk factors for the development of negative consequences.
During the first six months of treatment with sodium valproate, it is important to constantly monitor the state of the blood coagulation system, liver function, and peripheral blood patterns.
In people taking any anticonvulsant medication, sodium valproate therapy should be started gradually so that an effective dose is reached after approximately 12-14 days. After that, it is also necessary to gradually cancel the previously taken anticonvulsant drugs. If such drugs have not been previously used by the patient, then the effective dose to obtain a clinical result should be achieved in a week.
Against the background of the use of the drug, care must be taken when driving vehicles and carrying out work that requires concentration of attention and a high speed of psychomotor reactions.
And most importantly…
The basis for starting the use of any antiepileptic drug (sodium valproate is no exception) is a prescription from the attending physician.
He alth worker onlyis able to evaluate all factors and make a decision on conducting therapy with the use of a particular drug. Self-administration of such serious medications is fraught with very, very negative consequences for he alth - up to coma and death.
