두부외상 환자에서 Valproate의 대사의 변화

Abstract

Purpose：Traumatic brain injuries induce plasma clearance of several compounds. Phenytoin is usually used for the prevention of posttraumatic seizure, and it is known that its clearance is increased in traumatic brain injury patients. Valproate is another important anti-epileptic drug for the prevention of posttraumatic seizure. We evalua-ted the metabolism of valproate in acute traumatic brain injury patie-nts.

Methods：Fourteen traumatic brain injury patients were selected. They were given a loading dosage (15-20 mg/kg), and maintained with valproate. Trough serum valproate level was obtained during 7-20 days after an acute injury.

Results：The total clearance level of valproate was higher in ac-ute traumatic brain injury patients than patients with chronic valproate use (7.70±1.36 ml/kg/hr vs. 9.05±1.91 ml/kg/hr, p<0.05).

Conclusions：Acute traumatic brain injury results in the induction of valproate metabolism during 7-20 acute days, and it is related to the enhancement of multiple metabolic pathways.