NAPLEX Practice Question # 39

NAPLEX Examination.

Practice Question # 39.






VPA is generally initiated at doses of 20 to 30 mg/kg/day given in divided doses for inpatients and 250 mg three times daily for outpatients. Th e current therapeutic range (50 to 125 g/mL) was originally described for the treatment of seizure disorders and has not been established for effi cacy in bipolar disorder. Th e extended-release formulation has a 15% to 25% decreased bioavailability there requiring a 25% dose increase when switching from an immediate-release formulation.

  • Levels may be fi rst obtained aft er 3 to 5 days of therapy. Th ese values should be trough values and obtained 12 hrs following a dose. Th e monitoring of VPA levels can occur less frequently (every 6 to 12 months) in clinical stable patients.
  • Patients that are treated for 4 to 6 weeks with VPA concentrations of 80 to 120 g/mL without clinical response may be classifi ed as failures of VPA therapy.

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