Abstracts

RATIONALE: IV Valproate (VPA) was approved on April 1, 1997. Limited data exists for pediatric patients under three years of age. METHODS: Pharmacy records were reviewed to identify all pediatric patients ? 3 years of age who received IV VPA from 1/1998 through 3/2000. Charts were reviewed for dosage by weight, infusion rate, underlying medical condition, concomitant medical therapies including other antiepileptic drugs. Additionally, side effects, complications of infusion and obtained serum levels were recorded. RESULTS: 14 patients with a total of 21 admissions were identified. Patient ages ranged from 16 days to 32 months, 10 were under 12 months, 6 between 12 and 24 months and 5 between 24-32 months of age. Of 21 admissions, 13 patients were on VPA at the time of hospitalization. They received 252 dosages both as loading and maintenance doses. Loading doses that were administered ranged from 10 to 50 mg/kg. IV infusion rates typically were 1-6mg/kg/min. There were no reported infusion rate or site complications, no cardiac arrhythmias, no cases of respiratory compromise and/or hepatic failure noted. In 10 incidences, patients were loaded for acute seizures with control achieved in all instances. Drug levels obtained were within therapeutic range. CONCLUSIONS: IV VPA is well tolerated in infants and young children across a wide range of dosages and infusion rates. This small series does not discount the potential risk for hepatic function in infants and young children. However, if clinically warranted, IV VPA is both efficacious and well tolerated in infants and young children.