Sodium valproate

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丙戊酸钠

A fatty acid with anticonvulsant and anti-manic properties that is used in the treatment of EPILEPSY and BIPOLAR DISORDER. The mechanisms of its therapeutic actions are not well understood. It may act by increasing GAMMA-AMINOBUTYRIC ACID levels in the brain or by altering the properties of VOLTAGE-GATED SODIUM CHANNELS.

The sodium salt form of valproic acid with anti-epileptic activity. Valproate sodium is converted into its active form, valproate ion, in blood. Although the mechanism of action remains to be elucidated, valproate sodium increases concentrations of gamma-aminobutyric acid (GABA) in the brain, probably due to inhibition of the enzymes responsible for the catabolism of GABA. This potentiates the synaptic actions of GABA. Valproate sodium may also affect potassium channels, thereby creating a direct membrane-stabilizing effect.

Discuss with women and girls of childbearing potential (including young girls who are likely to need treatment into their childbearing years), and their parents and/or carers if appropriate, the risk of AEDs causing malformations and possible neurodevelopmental impairments in an unborn child. Assess the risks and benefits of treatment with individual drugs. There are limited data on risks to the unborn child associated with newer drugs. Specifically discuss the risk of continued use of sodium valproate to the unborn child, being aware that higher doses of sodium valproate (more than 800 mg/day) and polytherapy, particularly with sodium valproate, are associated with greater risk.[new2012] 请告知有生育潜力的女性患者（包括可能需要治疗至育龄期的年轻女孩）及她们的父母和/或照料人有关抗癫痫药物（AEDs）对胎儿的致畸和引起神经发育障碍的风险。并请评估使用特定药物治疗的风险与益处。目前新药对胎儿的风险数据较少。请特别讨论持续使用丙戊酸钠对未出生的孩子的风险，注意更高剂量的丙戊酸钠（超过 800 毫克/天）和综合疗法（特别是使用了丙戊酸钠时）可能与更大的风险有关。 nice.org.uk/guidance/cg137

Sodium valproate

[GRADES OF RECOMMENDATION:C] WWE and their partners need to be informed about the possible adverse impact on long-term neurodevelopment of the newborn following in utero exposure to sodium valproate. 【推荐等级：C】应告知WWE及其伴侣，宫内暴露于VPA可能对其长期神经发育产生不利影响。 Exposure to sodium valproate and other AED polytherapy should be minimised by changing the medication prior to conception, as recommended by an epilepsy specialist after a careful evaluation of the potential risks and benefits. 孕前使用VPA和其他AEDs综合治疗的患者，应根据癫痫专家的评估和建议下，在孕前即更换药物，以最大限度减少风险。 https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/epilepsy-in-pregnancy-green-top-guideline-no-68/

Wherever possible sodium valproate should be avoided during pregnancy.For women of childbearing potential, particularly those women contemplating pregnancy, other antiepileptic drugs should be considered in preference to sodium valproate. However, sodium valproate might be the only effective antiepileptic drug for some women, and this should not preclude its use. 妊娠期间应尽可能避免使用VPA或包括VPA在内的综合治疗方案。对于育龄期女性，尤其是有计划怀孕的女性，应优先考虑除了VPA以外的AEDs（但在某些不得不使用VPA的情况下，仍应使用VPA）。 Scottish Intercollegiate Guidelines Network.Diagnosis and management of epilepsy in adults. SIGN 143. Edinburgh, SIGN, 2015. Available at: www.sign.ac.uk/guidelines/fulltext/143/index.html

[GRADES OF RECOMMENDATION:D] Women with epilepsy should be informed that sodium valproate is associated with a higher rate of teratogenicity compared to other antiepileptic drugs.Antiepileptic drug polytherapy regimens including sodium valproate are associated with higher rates of congenital malformations compared to regimens not including sodium valproate. D级推荐：应告知所有女性癫痫患者，与其他AEDs相比，使用VPA有更高的致畸率；与不包括VPA在内的综合治疗方案相比，包含VPA的综合治疗方案致畸率更高。 Scottish Intercollegiate Guidelines Network.Diagnosis and management of epilepsy in adults. SIGN 143. Edinburgh, SIGN, 2015. Available at: www.sign.ac.uk/guidelines/fulltext/143/index.html

Sodium dipropylacetate Depacon DPA sodium VALPROATE SODIUM 2-Propylpentanoic Acid Sodium Salt Sodium Valproate Sodium alpha-propylvalerate Ergenyl Valproate sodium (substance) Convulsofin Vupral Magnesium Valproate Valproic Acid Sodium Salt (2:1) Semisodium Valproate Calcium Valproate Depakote Divalproex Sodium Valproate Calcium Dipropyl Acetate

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