Valproic Acid: Medication Profile (Seizure, Migraine, Bipolar Mania)

Vocabulary-style flashcards covering key concepts about Valproic Acid from the provided notes, including use, mechanism, dosing, administration, side effects, contraindications, monitoring, and patient education.

Valproic acid

An anticonvulsant in the carboxylic acid derivatives class; used for epilepsy, migraine prevention, and manic phase of bipolar disorder; mechanism includes increasing brain GABA activity and suppressing excessive neuronal firing via Na+ and Ca2+ channel inhibition.

Class

Carboxylic acid derivatives (valproic acid is part of this class of anticonvulsants).

Therapeutic drug level

Target serum concentration for valproic acid is 50 to 100 mcg/mL.

Therapeutic uses

Treats epilepsy, prevents migraines, and manages the manic phase of bipolar disorder.

Mechanism of action

Protects the brain by calming GABA activity and blocking overactivation by inhibiting voltage-gated Na+ and Ca2+ channels.

Administration route

Oral (enteric-coated tablets to reduce GI upset; capsules can be opened) and intravenous (IV); IV preparations may be diluted.

Enteric-coated tablet

Oral tablet formulation designed to resist stomach acid and reduce GI irritation.

Common side effects

GI upset and indigestion.

Major adverse effects

Hepatitis/hepatotoxicity, pancreatitis, hyperammonemia, bone marrow suppression, and teratogenic effects.

Hyperammonemia

Elevated ammonia levels that can occur with valproic acid use and may contribute to neurologic symptoms.

Bone marrow suppression

Decreased bone marrow activity, potentially leading to cytopenias.

Teratogenic effects

Valproic acid may cause birth defects; constitutes a significant pregnancy risk.

Contraindications/precautions

Pregnancy and breastfeeding; liver disorder; thrombocytopenia; hyperammonemia; renal disease; use with other anticonvulsants.

Drug interactions

Increases blood levels of phenytoin and phenobarbital; interactions with topiramate may raise ammonia levels; caution with other anticonvulsants.

Monitoring/interventions

Monitor liver function tests (LFTs), platelets/bleeding time, and ammonia levels; assess for bleeding, jaundice, contusions; use the lowest effective dose.

Nursing considerations

Educate on signs of hepatitis/hepatotoxicity; monitor for convulsions or decreased LOC; do not stop abruptly.

Patient education

Report signs of liver dysfunction, avoid abrupt discontinuation, and inform caregivers to monitor for adverse effects and changes in mental status.

Expected outcomes

Control seizures, maintain mood stability, and reduce migraine frequency.