M A Khobrani1,2, S W Dudley3, Y C Huckleberry4, B J Kopp4, A D Biggs5, R N E French3,6, F M Shirazi3,6, B L Erstad1. 1. Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA. 2. Department of Pharmacy Practice & Science, College of Pharmacy, King Khalid University, Abha, Saudi Arabia. 3. Arizona Poison & Drug Information Center, College of Pharmacy, The University of Arizona, Tucson, AZ, USA. 4. Department of Pharmacy Services, Banner University Medical Center - Tucson, Tucson, AZ, USA. 5. Department of Pharmacy Services, Froedtert Hospital, Milwaukee, WI, USA. 6. Department of Emergency Medicine, Banner University Medical Center - Tucson, Tucson, AZ, USA.
Abstract
WHAT IS KNOWN AND OBJECTIVE: The interaction between valproic acid (VPA) and carbapenem antibiotics is well described with previous reports suggesting a reduction in VPA half-life between 47% and 90%. As described in this case, this interaction might be beneficial in the setting of toxic VPA ingestion. CASE DESCRIPTION: An intubated, unresponsive patient arrived via emergency medical services after toxic VPA ingestion. Meropenem was prescribed for a suspected pneumonia and to take advantage of the VPA interaction. We observed a 56% decline in half-life with short-term meropenem dosing and an improvement in mental status shortly after administration. WHAT IS NEW AND CONCLUSION: Our findings suggest a potential role for short-term carbapenem therapy for VPA overdose.
WHAT IS KNOWN AND OBJECTIVE: The interaction between valproic acid (VPA) and carbapenem antibiotics is well described with previous reports suggesting a reduction in VPA half-life between 47% and 90%. As described in this case, this interaction might be beneficial in the setting of toxic VPA ingestion. CASE DESCRIPTION: An intubated, unresponsive patient arrived via emergency medical services after toxic VPA ingestion. Meropenem was prescribed for a suspected pneumonia and to take advantage of the VPA interaction. We observed a 56% decline in half-life with short-term meropenem dosing and an improvement in mental status shortly after administration. WHAT IS NEW AND CONCLUSION: Our findings suggest a potential role for short-term carbapenem therapy for VPAoverdose.