This document provides information about sodium valproate, including its uses, pharmacology, therapeutic indications, contraindications, adverse effects, and nursing implications. Sodium valproate is used to treat bipolar disorder and other mental health conditions. It is rapidly absorbed and has a half-life of 8-17 hours. Common side effects include nausea, vomiting, liver problems, and bleeding issues. Nurses should monitor patients for therapeutic effects and side effects and educate patients about proper administration and risks during pregnancy.

1. SODIUM VALPROATE
PRESENTED BY
ANUMOL TOMY
MSC NURSING 1ST YEAR

2. INTRODUCTION
Valproate ( Depakene, Depakote) is used
to treat bipolar I disorder & is equal in
efficacy & safety to lithium . Valproate is
also used in treatment of schizoaffective
disorders, impulse control disorders &
behavioural agitation. Valproate is an
effective prophylaxis against migraine
headaches.

3. CHEMISTRY
Available formulations include valproic
acid (Depakene); divalproex ,a 1:1
mixture of valproic acid & sodium
valproate. Valproate is also called
valproic acid because it is rapidly
converted to the acid forms in the
stomach.

4. PHARMACOLOGICAL ACTION
All valproate formulations are rapidly &
completely absorbed after the oral
administration .The steady half life of valproate
is about 8-17 hours,& clinically effective
plasma concentrations can be usually be
maintained with dosing one to four times a
day. Protien binding becomes saturated &
concentrations of therapeutically effective free
valproate increase at serum concentrations
above 50-100 ug/mL.

5. CONTD….
The therapeutic effects of valproate in
bipolar I disorder may be mediated by as
yet undefined effects of the drug on
gamma aminobutyric acid neurotransmitter
system.

6. THERAPEUTIC INDICATIONS
Bipolar I disorder
Schizoaffective disorder
Other mental disorder-It is effective for the
treatment of intermittent explosive disorder,
kleptomania,& other behavioural dyscontrol
syndromes, particularly if these disorders are
comorbid with bipolar symptoms..

7. CONTD….
Valproate can effectively control physical
aggression, restlessness, agitation,& to a
lesser degree, verbal aggression
associated with dementia ,organic brain
disease or traumatic brain injury

8. CONTRAINDICATIONS
Pregnancy
Lactating mothers
Bleeding disorders
Hepatic disorders
Renal diseases

9. DIAGNOSTIC TEST INTERFERENCE
Valproic acid produces false positive
results for urine ketones, elevated
AST, ALT, LDH , serum alkaline
phosphatase, prolonged bleeding time,
altered thyroid time.

10. ADVERSE EFFECTS
CNS-Seizures,increased
alertness,hallucinations,aggression,sedation,
GI- Nausea ,vomiting, indigestion , hyper
salivation ,anorexia with weight loss, abdominal
cramps with diarrhoea, hepatic failure.
Hematolgical-Prolonged bleeding time ,
leukopenia, thrombocytopenia ,bone marrow
depression & anemia.
Other-Skin rashes, transient hair loss, irregular
menses, secondary ammenhorea
Overdose-Deep coma ,pulmonary edema,death

11. NURSING IMPLICATIONS
ADMINISTRATION
Tablets & capsules should not be chewed. It should be
swallowed the whole.
To reduce gastric irritation administer drug with food
.Enteric coated tablets or syrup is well tolerated.
Abrupt discontinuation of the drug can lead to loss of
seizure control. Warn the patient not to not to stop or
alter the treatment regimen without consultation.

12. ASSESSMENT
Therapeutic effectiveness is indicated by
decrease in BP.
Periodically monitor liver functions,BUN &
creatinine,serum potassium,CBC.

13. PATIENT TEACHING
oWomen who become pregnant should
immediately inform their physicians.
oWeight gain is a common side effect
especially in long term treatment & can be
treated by limited calorie intake.
oThe risk of valproate inducedneural tube
defects can be reduced by administration of
folic acid supplements.

14. Any question:

15. THANK U