Acute Valproic Acid Intoxication: A Case Report

急性丙戌酸中毒：病例報告

吳銘斌(Ming-Pin Wu) ； 吳佩真(Pei-Chen Wu) ； 廖晏辰(Yen-Chen Liao) ； 黃國泰(Kuo-Tai Hung)

《台灣急診專科醫師期刊》 5卷1期 (2013/03) Pp. 14-18

摘要

急性丙戊酸(Acute valproic acid)中毒通常只造成輕度的中樞神經障害，但嚴重的中毒症狀甚至死亡也曾被報導。臨床表現色括中樞神經抑制、低血壓、呼吸抑制、代謝性酸中毒及電解質異常。我們提出一位罹患躁鬱症的年輕男性因意識不清送至急診，腦部電腦斷層正常，血中丙戊酸的濃度高達711.4ug/ml且血氨(ammonia)濃度大於400ug/dl；因未知藥物使用的時間所以並未使用活性碳灌食，處方的藥物中包括naloxone及carnitine，腎臟科醫師也建議安排血液透析，經過積極的處置之後病人順利復原並未留下任何後遺症。

關鍵字

丙戌酸 ； 氨

並列摘要

Acute valproic acid (VPA) intoxication usually results in mild, self limited central nervous system (eNS) dysfunc tion , bu t serious toxicity and death have been rep orted. Here we present a young male with bipolar disorder who was sent to emergency department due to unconsciousness. Brain computed tomography was normal. VPA level was 711.4ug/ml and ammonia level was 400ug/dl. Activated charcoa l was withheld due to unknown period of exposure. Naloxone and carnitine were prescribed. Nephrologist also recommended hemodialysis. Patient recovered without any sequel after treatment.

並列關鍵字

vaJproic acid ； ammonia