Sodium valproate: prescription, instruction, form of release, mechanism of action, formula

Any disorders of the functioning of the central nervous system require close attention to themselves. To combat this kind of problems, a lot of medications have been developed with different principles of influence on the brain. One of them is "Sodium valproat".

Main components and form of release

The main active ingredient of the drug - the sodium salt of valproic acid - is a fine crystalline powder of white color, odorless. This is the form of the release of the drug "Sodium valproate". Formula - C8H15NAO2. Easily soluble in alcohol and water.

The consumer is offered in tablets and polyethylene two-layer bags. The minimum possible volume in one package is 0.5 kg. Further by increasing: 1, 2, 5, 10, 20, 25, 30, 40, 50, 65 kg.

Pharmacodynamics

Antiepileptic means - 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 that is the most important inhibitory neurotransmitter of humans and other mammals) in the central nervous system 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 excitability and predisposition of the motor zones 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 antiarrhythmic effect. The drug shows high efficiency in absences (symptom of epilepsy, one of the types of epileptic attack) and temporal pseudoabsances, but practically has no effect on the state of patients with the development of psychomotor seizures.

Scope of the drug

The main area 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 a convulsive syndrome, often accompanying organic diseases of the human nervous system, behavior disorders, usually going hand in hand with epilepsy, with febrile convulsions and nervous tics in child patients.

Valproate sodium instruction recommends the admission to patients suffering from manic-depressive psychosis with bipolar flow in those cases if the disease can not be treated with lithium and other medications.

Who is not allowed to use the medication?

At such complex preparations, as antiepileptic, always there is a certain list of contraindications for their application. You can not take a remedy for those who are hypersensitive to a substance such as valproic acid (sodium valproate, in fact, consists of its sodium salt). The basis for refusing to use is the presence in patients of functional abnormalities in the liver and / or pancreas. Separately, it is worth highlighting in this group of diseases hepatitis (any form - acute, chronic, drug, etc., including in the history of family members).

Do not prescribe this drug for hemorrhagic diathesis, porphyria (in almost 99% of cases, hereditary deviation, manifested in the violation of pigmental exchange with a high content of blood and tissues of porphyrins).

Valproate sodium and pregnancy

The use of medication in the first trimester of pregnancy is contraindicated. In the second and third trimester, the doctor will prescribe a prescription for the purchase of the drug "Sodium valproate" only if the expected effect for the mother exceeds the potential risk for the child.

Patients should be notified that valproic acid is capable of provoking a number of congenital anomalies in the fetus. In addition, this substance is excreted in breast milk (concentrations can reach 10% of the amount that is contained in the blood plasma of the mother). Therefore, breastfeeding against the background of therapy with medicines containing valproic acid is acceptable only in cases of extreme necessity.

As a universal recommendation to women in reproductive age, there will be the use of reliable means or methods of contraception.

Undesirable effects

For patients undergoing treatment with Sodium Valproate, the instructions for use contain information on possible side effects from different systems and organs.

Possible response from the central nervous system can be tremor, mood changes, behavior, coordination disorders, drowsiness, dizziness and headaches, irritability, motor anxiety and unusual arousal.

Possible reactions of the gastrointestinal tract are loss of appetite, dyspepsia, nausea, vomiting, diarrhea, small cramps in the intestine or stomach. It is rare to hear about constipation or pancreatitis. Women may have a menstrual cycle. Often there are fluctuations in weight in one direction or another. A coagulation system can respond with thrombocytopenia, an increase in the amount of time it takes to stop bleeding. Possible dermatological abnormalities in the form of alopecia (abnormal hair loss), allergic - in the form of a rash on the skin.

Drug Administration Schedule

The dosage regimen for each patient is strictly individual. "Valproate sodium", whose form of release - in the form of a powder, is prescribed depending on the 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 adverse events 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.

Treatment regimen with medication - 2-3 times a day during meals.

Practice is also the administration of sodium valproate intravenously (allowable volume 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 for adults and children weighing more than 25 kg is 50 mg / kg per day. If, for whatever reason, it is necessary to increase its (dose), a prerequisite is monitoring the concentration of valproate in the blood plasma. If this figure is more than 200 mg / l - the dosage should be reduced.

Exceeding the permissible dose

If, for any reason, the permissible dose of "Sodium valproate" (a prescription in Latin is not available to all patients for understanding) has occurred, there are a number of unambiguous symptoms. The most frequent reactions are disorders of coordination of movements and balance, inhibition, myasthenia gravis (pathologically fast fatigue), hyporeflexia, nystagmus (involuntary eye oscillations with high frequency), miosis (constriction of the pupil), heart block, coma.

The treatment is performed in a hospital and consists of washing the stomach (it will be effective with enteral administration no later than 10-12 hours), in providing osmotic diuresis (large volume of urine with a high concentration of active osmotic components) and supporting vital body functions. A good effect will give hemodialysis.

Interaction with other substances

When used in parallel with other neuroleptics, antidepressants, MAO inhibitors, various kinds of ethanol derivatives and benzodiazepine sodium valproate will increase the inhibitory effect on the central nervous system. Joint use of the drug with hepatotoxic drugs, antiplatelet agents, anticoagulants, possibly, will provoke an increase in the effect of these substances.

Parallel administration of valproic acid and phenobarbital will lead to the displacement of the latter from the bond with plasma proteins. Consequence - an increase in its (phenobarbital) concentration in blood plasma.

In general, sodium valproate can interact with a variety of medications, so the treating doctor should notify the patient about possible (or unacceptable) concurrent administration with other medications.

Special instructions

With great caution the medication is prescribed for patients suffering from liver and pancreas diseases (or having them in anamnesis), children under 3 years of age (the risk of hepatotoxicity is maximal, but decreases with age). It must be borne in mind that the likelihood of negative effects on the part of the liver increases with combined anticonvulsant therapy.

Very attentive to their health condition should be patients who take "Sodium valproate" and have pathological changes in blood. Organic diseases of the brain, abnormalities in the functioning of the kidneys, hypoproteinemia are also quite serious risk factors for the development of negative consequences.

During the first half-year of treatment with sodium valproate, it is important to carry out constant monitoring of the state of the blood coagulation system, liver function, peripheral blood picture.

For people taking any anticonvulsant medications, sodium therapy with valproate should be started gradually, in such a way as to achieve an effective dose in about 12-14 days. After that, as gradually it is necessary to cancel previously taken anticonvulsant drugs. If such drugs were not previously used by the patient, then an effective dose for obtaining 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 works that require concentration of attention and high speed of psychomotor reactions.

And the most important thing…

The basis for starting the use of any antiepileptic drug (not an exception and sodium valproate) is the prescription of the attending physician.

Only a health worker is able to evaluate all factors and make a decision to conduct therapy with the use of a particular drug. Self-assignment of such serious medications is fraught with very, very negative consequences for the state of health - up to coma and death.