{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T16:24:12Z","timestamp":1762100652169,"version":"build-2065373602"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T00:00:00Z","timestamp":1325808000000},"content-version":"vor","delay-in-days":1741,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2007,4]]},"abstract":"<jats:p><jats:bold>Study Objective<\/jats:bold>. To describe the dose\u2010concentration relationship of a continuous intravenous infusion of valproic acid (VPA) in pediatric patients when a dosing protocol is used.<\/jats:p><jats:p><jats:bold>Design<\/jats:bold>. Retrospective and concurrent chart review.<\/jats:p><jats:p><jats:bold>Setting<\/jats:bold>. Tertiary care, 473\u2010bed, academic medical center with a 120\u2010bed, dedicated children's hospital.<\/jats:p><jats:p><jats:bold>Patients<\/jats:bold>. Twenty\u2010six pediatric patients (&lt; 18 yrs old) who received VPA according to the protocol for continuous intravenous infusions between January 1, 2004, and March 31, 2006, identified by using a pharmacy order\u2010entry system.<\/jats:p><jats:p><jats:bold>Measurements and Main Results<\/jats:bold>. Patient demographics, VPA treatment regimens, clinical responses, and safety data were recorded and analyzed. Median patient age was 8.5 years (range 1.4\u201316 yrs). Approximately two thirds received VPA for seizures, and one third for migraines. Patients were given a mean \u00b1 SD VPA loading dose of 28.5 \u00b1 5.2 mg\/kg followed by a continuous infusion rate of 1 \u00b1 0.2 mg\/kg\/hour. Mean \u00b1 SD serum concentration measured 4.5 \u00b1 1.6 hours after the loading dose was 83.3 \u00b1 22.8 \u03bcg\/ml. Steady\u2010state concentration at 23.3 \u00b1 3.0 hours after the start of the continuous infusion was 80.0 \u00b1 26.0 \u03bcg\/ml. Postload and steady\u2010state serum concentrations were within the target concentration of 50\u2013100 \u03bcg\/ml in 77% and 69% of patients, respectively. On further analysis, when the target range was expanded to 50\u2013125 \u03bcg\/ml (125 \u03bcg\/ml was deemed acceptable if no adverse effects were noted), 89% and 92% of patients, respectively, had postload and steady\u2010state VPA serum concentrations within this range. The response rate was excellent, with nearly 85% of patients achieving a complete or partial response to therapy. Adverse effects were generally mild and uncommon.<\/jats:p><jats:p><jats:bold>Conclusions<\/jats:bold>. The continuous\u2010infusion protocol permitted rapid intravenous loading of VPA in pediatric patients while minimizing adverse events and achieving concentrations in the upper region of the therapeutic range.<\/jats:p>","DOI":"10.1592\/phco.27.4.519","type":"journal-article","created":{"date-parts":[[2007,3,26]],"date-time":"2007-03-26T08:47:38Z","timestamp":1174898858000},"page":"519-525","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Clinical Utility of a Continuous Intravenous Infusion of Valproic Acid in Pediatric Patients"],"prefix":"10.1002","volume":"27","author":[{"given":"Lisa M.","family":"Taylor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farjam","family":"Farzam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron 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