Romanian Society of Pharmaceutical Sciences
 

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FAVOURABLE RESULTS FOR L-CARNITINE USE IN VALPROIC ACID ACUTE POISONING

RADU CIPRIAN ŢINCU 1,2#*, CRISTIAN COBILINSCHI 3#, DANA TOMESCU 4,5#, LAURENŢIU COMAN 6#, IULIA ŢINCU 7#, CAMELIA DIACONU 8#, RADU ALEXANDRU MACOVEI 1,2#

1.Clinical Emergency Hospital Bucharest, Critical Care Toxicology Unit, 8 Floreasca Way, 014451, Bucharest, Romania
2.“Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, Department of Orthopaedics – Anaesthesiology and Intensive Care, Discipline of Pharmacology, Toxicology and Clinical Psychopharmacology, 8 Floreasca Way, 014451, Bucharest, Romania
3.Clinical Emergency Hospital Bucharest, Anaesthesiology Intensive Care Unit, 8 Floreasca Way, 014451, Bucharest, Romania
4.“Fundeni” Clinical Institute, Anaesthesiology Intensive Care Unit, 258 Fundeni Street, 022328, Bucharest, Romania
5.“Carol Davila” University of Medicine and Pharmacy, Faculty of Medicine, Department of Orthopaedics – Anaesthesiology and Intensive Care, Discipline Anaesthesiology and Intensive Care, 258 Fundeni Street, 022328, Bucharest, Romania
6.“Carol Davila” University of Medicine and Pharmacy, Faculty of Pharmacy, Physiology Department, 6 Traian Vuia Street, 020956, Bucharest, Romania
7.“Grigore Alexandrescu” Emergency Children Hospital, Emergency Department, 30-32 Iancu de Hunedoara Avenue, 11743, Bucharest, Romania
8.“Carol Davila” University of Medicine and Pharmacy, Clinical Emergency Hospital Bucharest, Internal Medicine Unit, Bucharest, Romania

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Valproic acid (VPA) is a fatty acid with anticonvulsant properties. The aim of our present study was to investigate the effect of levo-carnitine supplementation on serum NH3 and clinical recovery in patients with VPA intoxication. This study included all patients admitted for acute VPA poisoning (VPA > 100 µg/mL), in 2014, in our clinic. Blood samples were obtained in order to analyse NH3, VPA concentrations and biochemical status. The patients were allocated to receive standard therapy (Group 1) or 1800 mg of L-carnitine/day together with standard therapy (Group 2) for 3 days. A total of 62 patients were finally enrolled in the study. The median (IQR) ingested dose of VPA was 1000 mg (800 mg, 1200 mg [range; 800 - 6000 mg]). L-Carnitine supplementation resulted in significant reductions in ammonemia (47.9 ± 6 vs. 61.9 ± 11.39 μmol/L), determined after 24 hours, levels compared with baseline (p < 0.001). The trend was similar for plasma VPA levels. The use of L-carnitine accelerates the elimination of VPA and facilitates the decrease in ammonia plasma levels.