Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2008-2-1
pubmed:abstractText
This study tested the hypothesis that the determinants of mild liver injury are prerequisites for more severe idiosyncratic hepatotoxicity. This study verified whether the possible risk factors for rare idiosyncratic valproic acid (VPA)-induced hepatotoxicity, VPA clearance and/or serum carnitine concentrations are common to those for a mild elevation in transaminases in VPA-treated patients. VPA clearance was calculated in 172 Japanese patients with epilepsy, using a non-linear mixed-effects regression program. Carnitine concentrations were determined in a subset of 60 patients. The relationships between VPA clearance, carnitine concentration and levels of transaminases and ammonia were evaluated by Pearson's correlation coefficients. The final model of VPA apparent clearance (CL/F) was as follows: CL/F (L h(-1) = 0.012 x (BW/40)(0.34) x dose(0.55) x 0.90(gender) x 1.32(PHT) x 1.11(CBZ) x 1.12(PB), where BW = total body weight (kg); gender = 1 if female, 0 if male; PHT/CBZ/PB = 1 if phenytoin, carbamazepine, or phenobarbital, respectively, is coadministrated, otherwise 0. Either a higher VPA clearance or acyl/free carnitine ratio and a lower total and/or free carnitine concentration, but not VPA concentration, were associated with the mild elevation in transaminases or ammonia. These results support the initial hypothesis, while also helping to clarify the mechanism of severe idiosyncratic hepatotoxicity with VPA.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0022-3573
pubmed:author
pubmed:issnType
Print
pubmed:volume
60
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
267-72
pubmed:dateRevised
2009-11-19
pubmed:meshHeading
pubmed-meshheading:18237476-Adolescent, pubmed-meshheading:18237476-Adult, pubmed-meshheading:18237476-Ammonia, pubmed-meshheading:18237476-Anticonvulsants, pubmed-meshheading:18237476-Body Weight, pubmed-meshheading:18237476-Carnitine, pubmed-meshheading:18237476-Child, pubmed-meshheading:18237476-Child, Preschool, pubmed-meshheading:18237476-Drug Interactions, pubmed-meshheading:18237476-Drug-Induced Liver Injury, pubmed-meshheading:18237476-Epilepsy, pubmed-meshheading:18237476-Female, pubmed-meshheading:18237476-Humans, pubmed-meshheading:18237476-Infant, pubmed-meshheading:18237476-Japan, pubmed-meshheading:18237476-Liver Function Tests, pubmed-meshheading:18237476-Male, pubmed-meshheading:18237476-Middle Aged, pubmed-meshheading:18237476-Regression Analysis, pubmed-meshheading:18237476-Risk Factors, pubmed-meshheading:18237476-Sex Factors, pubmed-meshheading:18237476-Transaminases, pubmed-meshheading:18237476-Valproic Acid
pubmed:year
2008
pubmed:articleTitle
Potential relationships between transaminase abnormality and valproic acid clearance or serum carnitine concentrations in Japanese epileptic patients.
pubmed:affiliation
Division of Pharmacology and Therapeutics, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
pubmed:publicationType
Journal Article, Clinical Trial, Research Support, Non-U.S. Gov't