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Valproic Acid. Software and Presentation by: Ted, Rob, Jeff, Cassie, Tristan, Korin, Ron, Gabe, Matt, Judith, Lindsay. General Information. Used in the management of multiple seizure types. Oral and IV forms
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Valproic Acid Software and Presentation by: Ted, Rob, Jeff, Cassie, Tristan, Korin, Ron, Gabe, Matt, Judith, Lindsay
General Information • Used in the management of multiple seizure types. • Oral and IV forms • Also indicated for management of bipolar affective disorder and possible migraine prevention. • Increases body’s production and response to GABA.
Therapeutic / Toxic Conc’s • Cpss range- 50 to 100 mcg/ml. • Upper limit of 175mcg/ml with proper monitoring. • At concentrations >75 mcg/ml some patients may experience adverse effects.
Basic Clinical Pharmacokinetics • Exhibits concentration dependant protein binding • Follows Non-Linear Kinetics • Highly protein bound to albumin • Follows a basic 1-Compartment Model.
Clinical Implications • Clearance is now dose or concentration dependant. • Volume of Distribution is now affected by concentration-dependant plasma protein binding and its value should be 0.15 to 2.0 L/kg. • Half Life 12 to 18 hrs for adults and is found by the eqn. t1/2=0.693xVd/Cl
Software Structure • Functional components of the software were segmented into “tiers” to make the application to support ease of use and maintainability • Core • Peripheral • Variable Core Peripheral Variable
Core Components • Contains foundational assumptions of the software • User Input requirements • Kinetic Models • Changing the Core will cause global changes to functionality and require massive reworking of the system • Intolerant to changes Core Peripheral
Peripheral Components • Contains slowly changing parameters • Changes cascade to most sections of the software • Changes tolerated, but should be rare and hidden from most users • Provides extensibility of the application • Includes reports charts, kinetic parameters Peripheral Core Peripheral
Variable Components • Continuously changing • High tolerance to changes, incorrect / inappropriate input • Patient Cases Core Peripheral Variable
Bayesian Pharmacokinetics • Estimate drug dosage or steady state plasma concentration • Patient’s parameters (age, weight, sex, serum creatine) • Absence of or with measured drug levels • DrugCalc shareware software • Dr. Dennis Mungall • Nonlinear regression • One-compartment model
DrugCalc Example • Enter patient’s demographic, drug dosing, and serum concentration • Compute the pharmacokinetic parameters • Compute desired dose to achieve steady state concentration