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
Epilepsiajournal_title
Epilepsiaauthors
Warter JM,Marescaux C,Brandt C,Rumbach L,Micheletti G,Chabrier G,Imler M,Kurtz Ddoi
10.1111/j.1528-1157.1983.tb03428.xsubject
Has Abstractpub_date
1983-10-01 00:00:00pages
628-33issue
5eissn
0013-9580issn
1528-1167journal_volume
24pub_type
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