Should Pharmacies Be Included in Medication Reconciliation? A Report of Recurrent Valproic Acid Toxicity

Autor: B. Tate Cutshall, Samarth P. Shah, Megan A. Van Berkel, Shanise Patterson, L. Jeff Harris, Jessica V. Rivera
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Clinical Practice and Cases in Emergency Medicine, Vol 1, Iss 2 (2017)
Druh dokumentu: article
ISSN: 2474-252X
DOI: 10.5811/cpcem.2016.12.33002
Popis: Including outpatient pharmacies in the medication reconciliation process upon hospital discharge is not commonly performed. This case highlights the consequences of a patient refilling a discontinued prescription for valproic acid (VPA). We present a 32-year old male found unresponsive after ingesting delayed release divalproex sodium. Cerebral edema was visualized on magnetic resonance imaging. Hemodialysis and levo-carnitine treatment led to improved mental status, and VPA was discontinued. The same patient presented with VPA overdose eight months later after he continued to fill an outdated prescription. This case highlights consequences of VPA toxicity; it also demonstrates an opportunity to improve patient safety and high-value care by collaborating with outpatient pharmacies in the medication reconciliation process upon hospital discharge.
Databáze: Directory of Open Access Journals