Sodium valproate associated with phenobarbital: effects on ammonia metabolism in humans.

Abstract:

:Treatment with sodium valproate (VPA) in association with phenobarbital (PB) is accompanied by a greater systemic hyperammonemia than treatment by VPA alone. The anatomical origins of this difference were studied by injecting a dose of 1,500 mg VPA i.v. into six unmedicated patients and six epileptics chronically treated with PB and measuring the ammonium (NH4+) concentration difference between arterial blood and renal, hepatic, internal jugular, and femoral venous blood. In unmedicated patients, arterial [NH4+] rose moderately, secondary to an increased amount of NH4+ released into the general circulation by the kidney; the hepatic metabolism of NH4+ remained normal. In epileptics treated with PB, arterial [NH4+] rose massively, partly as a result of the increased NH4+ release by the kidney and partly because of disturbance of the hepatic metabolism of NH4+. These results provide a clearer understanding of the potentiation of the secondary effects of VPA by PB.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Warter JM,Marescaux C,Brandt C,Rumbach L,Micheletti G,Chabrier G,Imler M,Kurtz D

doi

10.1111/j.1528-1157.1983.tb03428.x

subject

Has Abstract

pub_date

1983-10-01 00:00:00

pages

628-33

issue

5

eissn

0013-9580

issn

1528-1167

journal_volume

24

pub_type

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