Abstracts

Traumatic brain injuries induce plasma clearance of several compounds. Phenytoin is usually used 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 prevention of posttraumatic seizure. We evaluated the metabolism of valproate in acute traumatic brain injury patients. Twenty-five acute traumatic brain injury patients were selected. They were received loading dosage (15 - 20 mg/kg) and maintain with valproate. Trough serum valproate level was obtained between 7 - 20 days after acute brain injury. We calculated clearence level of valproate of each patients and compared with the clearence rate of chronically valproate use patients. The total clearance rate of valproate was increased in acute traumatic brain injury patients than chronically valproate use patients (6.71 [plusmn] 1.58 ml/kg/hr vs. 9.13 [plusmn] 2.18 ml/kg/hr, p[lt]0.05). Acute traumatic brain injury results in induction of valproate metabolism during acute 7-20 days and it is related to enhance of multiple metabolism pathway.