Mood Stabilizers · Anticonvulsant Mood Stabilizers
Valproate
Brand: Depakote (delayed-release), Depakote ER (extended-release), Depakene (valproic acid), Depacon (IV formulation)
Mood stabilizer / anticonvulsant (multiple mechanisms)
14 cards
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core (2)risk (3)interaction (2)trap (3)dosing (1)monitoring (2)population (1)
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1.What is valproate's therapeutic level range and its three FDA boxed warnings?
2.Why is valproate essentially contraindicated in reproductive-age women?
3.How does valproate affect lamotrigine levels, and why is this dangerous?
4.A patient on valproate has a total level of 75 mcg/mL but appears toxic. Albumin is 2.1. Why?
5.How can valproate be loaded for acute inpatient mania?
6.What labs should be monitored with valproate?
7.What is valproate-induced hyperammonemia and why is it a trap?
8.A reproductive-age woman on valproate asks about pregnancy. What is your response?
9.What endocrine/metabolic side effects are associated with valproate?
10.What are valproate's multiple mechanisms of action?
11.Describe the bidirectional valproate-carbamazepine interaction.
12.When should you order a free (unbound) valproate level?
13.A patient on valproate with a level of 110 mcg/mL develops easy bruising. What happened?
14.What populations are at highest risk for valproate-induced fatal hepatotoxicity?
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