Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Depakene is an antiepileptic and mood stabilizer approved for treatment of seizures, manic episodes associated with bipolar disorder, and migraine prophylaxis. Mechanistically, it blocks voltage-dependent sodium and calcium channels, increases Þ- aminobutyric acid (GABA) synthesis, potentiates GABA activity at postsynaptic receptors, blocks GABA degradation, and attenuates the activity of glutamate upon N-methyl-D-Aspartate receptors (Perucca E.2002 & Rosenberg G.2007). Recently, valproate has been administered to critically ill patients to treat agitation and delirium, but there are few published reports to support this practice (Bourgeois JA,et al.2005),( SherY, et al.2015) & (Fitz K, Harding A.2011).Valproate is an emerging treatment for ICU agitation because it allows patients to interact with their caregivers; can be administered outside of the ICU; has both an intravenous (IV) and enteral formulation; has a low drug acquisition cost; and has not been associated with respiratory depression, hemodynamic derangements, or delirium

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