Valproate

Question 1

Drug Class

Answer 1

Antiepileptics

Question 2

Active

Answer 2

Valproate

Question 3

Indications

Answer 3

- Primary generalised epilepsy 
       • absence
       • tonic-clonic
       • myoclonic and atonic seizures
and simple and complex partial (focal) seizures

• Bipolar disorder
• Prevention of migraine when other treatments have failed

Question 4

Dose Range

Answer 4

Epilepsy/bipolar
Initially, oral 600 mg daily in 2 doses; increase every 3 days by 200 mg daily according to response

Prevention of migraine
200–400 mg twice daily

Question 5

SE’s

Answer 5

all antiepileptics cause ‘RADS’ = rash, ataxia, dizziness, sedation

• n/v
• increased appetite/weight gain
• tremor
• thinning/loss of hair
• thrombocytopenia

Question 6

Counselling

Answer 6

Labels: A, B, 9, 10a, 12+, 13

• Take with food to reduce stomach upset.
• Swallow the enteric coated tablets whole; do not crush or chew them.
• Valproate may make you feel drowsy; if affected, do not drive or operate machinery.
• This medicine may also increase the effects of alcohol.
• Your appetite may increase when taking this medicine and you may need to pay more attention to your diet to avoid weight gain.
• Tell your doctor immediately if symptoms such as fever, rash, abdominal pain, vomiting, jaundice, bruising or bleeding develop.
• Do not stop taking this medicine suddenly unless your doctor tells you to.
• May increase bleeding. therefore, no more than one aspirin daily

Question 7

Monitoring

Answer 7

• complete blood count (including platelets) before starting treatment.
• liver aminotransferase concentration
• BMD (long term use increases the risk of fracture). Ensure vitamin D status and calcium intake are adequate.