{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:20:53Z","timestamp":1789662053776,"version":"4.0.1"},"reference-count":14,"publisher":"Walter de Gruyter GmbH","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_dmpt-2019-0028_abs_001_w2aab3b7b8b1b6b1aab1c15b2Aa\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Valproic acid (VPA) is an anticonvulsant used in several clinical scenarios. VPA has been increasingly associated with intentional or unintentional overdose. In patients presenting with severe VPA overdose, supportive care and airway protection are cornerstones of treatment, while levocarnitine is suggested in patients with hyperammonemia and hemodialysis is recommended in patients with VPA serum concentrations (SC) &gt;1,300\u00a0mg\/L and presence of cerebral edema or shock. Meropenem is a carbapenem antibiotic with a broad spectrum of activity. The pharmacological interaction between VPA and meropenem is characterized by a rapid decrease in VPA concentrations, which contraindicates concurrent use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_dmpt-2019-0028_abs_002_w2aab3b7b8b1b6b1aab1c15b3Aa\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>The following case report describes the use of meropenem to enhance the clearance of VPA in the case of severe VPA overdose. A patient with altered mental status was transported to the emergency department (ED) after VPA overdose. Meropenem was prescribed for significant elevated VPA SC. An important decline in SC was observed with short-term meropenem dosing, and an improvement in mental status occurred shortly after administration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_dmpt-2019-0028_abs_003_w2aab3b7b8b1b6b1aab1c15b4Aa\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Carbapenem therapy has the potential to be used as last line strategy in the management of severe VPA overdose in patients where SC represent a significant risk of toxicity and clinical symptoms suggest difficulty managing the patient.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/dmpt-2019-0028","type":"journal-article","created":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T13:03:44Z","timestamp":1594386224000},"source":"Crossref","is-referenced-by-count":5,"title":["Meropenem for management of valproic acid overdose: a case report"],"prefix":"10.1515","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8667-8159","authenticated-orcid":false,"given":"Daniel","family":"Mu\u00f1oz-Pichuante","sequence":"first","affiliation":[{"name":"Universidad Austral de Chile , Facultad de Ciencias , Instituto de Farmacia , Valdivia , Chile"},{"name":"Hospital Base de Valdivia , Valdivia , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Villa-Zapata","sequence":"additional","affiliation":[{"name":"University of Colorado , Skaggs School Pharmacy and Pharmaceutical Sciences , Center for Pharmaceutical Outcomes Research , Denver , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russi","family":"Lolas","sequence":"additional","affiliation":[{"name":"Hospital Base de Valdivia , Valdivia , Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"key":"2022071513450991875_j_dmpt-2019-0028_ref_001_w2aab3b7b8b1b6b1ab2b1b1Aa","doi-asserted-by":"crossref","unstructured":"Spiller, HA, Krenzelok, EP, Krenzelok, EP, Klein-Schwartz, W, Winter, ML, Weber, JA, et al. Multicenter case series of valproic acid ingestion: serum concentrations and toxicity. J Toxicol Clin Toxicol 2000;38:755\u201360. https:\/\/doi.org\/10.1081\/clt-100102388.","DOI":"10.1081\/CLT-100102388"},{"key":"2022071513450991875_j_dmpt-2019-0028_ref_002_w2aab3b7b8b1b6b1ab2b1b2Aa","unstructured":"Center for Toxicological Information of the Pontifical Catholic University (CITUC). Scientific community. scientific articles. Characterization of overdoses with suicidal ideation, reported in the Center for Toxicological Information of the Pontifical Catholic University of Chile (CITUC), during the first half of 2018. Available from: https:\/\/cituc.uc.cl\/images\/articulos\/Poster_Iturra_1suicidas.pdf [Accesed 1 Oct 2019]."},{"key":"2022071513450991875_j_dmpt-2019-0028_ref_003_w2aab3b7b8b1b6b1ab2b1b3Aa","doi-asserted-by":"crossref","unstructured":"Wu, CC, Pai, TY, Hsiao, FY, Shen, LJ, Wu, FL. The effect of different carbapenem antibiotics (ertapenem, imipenem\/cilastatin, and meropenem) on serum valproic acid concentrations. Ther Drug Monit 2016;38:587\u201392. https:\/\/doi.org\/10.1097\/ftd.0000000000000316.","DOI":"10.1097\/FTD.0000000000000316"},{"key":"2022071513450991875_j_dmpt-2019-0028_ref_004_w2aab3b7b8b1b6b1ab2b1b4Aa","doi-asserted-by":"crossref","unstructured":"Ghannoum, M, Lalibert\u00e9, M, Nolin, TD, MacTier, R, Lavergne, V, Hoffman, RS, et al. Extracorporeal treatment for valproic acid overdose: systematic review and recommendations from the EXTRIP workgroup.Clin Toxicol 2015 Jun;53:454\u201365. https:\/\/doi.org\/10.3109\/15563650.2015.1035441.","DOI":"10.3109\/15563650.2015.1035441"},{"key":"2022071513450991875_j_dmpt-2019-0028_ref_005_w2aab3b7b8b1b6b1ab2b1b5Aa","doi-asserted-by":"crossref","unstructured":"Johannessen, CU. Mechanisms of action of valproate: a commentatory. 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