Sodium valproate-induced hyperlactatemia with metabolic acidosis
10.3760/cma.j.cn114015-20181221-01269
- VernacularTitle:丙戊酸钠致高乳酸血症伴代谢性酸中毒
- Author:
Zhizhou WANG
1
;
Hongqin CHENG
1
;
Xiangrong BAI
1
;
Ying JIN
1
;
Dechun JIANG
1
;
Shengpeng ZHANG
1
Author Information
1. 首都医科大学宣武医院药学部/国家老年病学临床研究中心，北京 100053
- Publication Type:Journal Article
- Keywords:
Valproic acid;
Epilepsy;
Acidosis, lactic
- From:
Adverse Drug Reactions Journal
2020;22(6):379-380
- CountryChina
- Language:Chinese
-
Abstract:
A 45-year-old male patient underwent craniotomy and biopsy for intracranial lesions. In order to prevent epilepsy, sodium valproate 800 mg dissolved in 0.9% sodium chloride injection 8 ml was injected intravenously after operation, and then the sodium valproate solution of this concentration was continuously pumped at a speed of 0.6 ml/h. One hour after administration, the serum lactate level of the patient increased gradually, reaching the highest level of 14.7 mmol/L, accompanied by metabolic acidosis and compensatory respiratory alkalosis, and with the lowest pH of 7.09 and the lowest base excess of -26.3. The patient fell into a coma. The hyperlactatemia and metabolic acidosis were considered to be related to sodium valproate. Sodium valproate was stopped, intravenous infusion of 5% sodium bicarbonate injection and blood purification were given at the same time. After 3 days, the lactate level of the patient returned to normal, metabolic acidosis was basically corrected, and his mind was clear.
