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Clinical Drug Investigation
Published in: Clinical Drug Investigation 3/2024

16-02-2024 | Valproate | Original Research Article

Safety of Intravenous Push Valproate Compared with Intravenous Piggyback at a Tertiary Academic Medical Center

Authors: Felicia Y. Wang, Kevin C. McLaughlin, Michael J. Schontz, Jeremy R. DeGrado, Robert E. Dannemiller

Published in: Clinical Drug Investigation | Issue 3/2024

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Abstract

Background and Objectives

Data are limited regarding the safety associated with administering valproate sodium by intravenous push (IVP) compared with intravenous piggyback (IVPB). The objective of this retrospective pre-post analysis was to compare the safety profile of valproate administration via IVPB from March to May 2022 and IVP from June to August 2022.

Methods

A total of 890 IVPB and 440 IVP administrations were included. The major endpoint of this analysis was the incidence of infusion site reactions (infiltration or phlebitis).

Results

The incidence of documented intravenous (IV) site reactions demonstrated minimal differences between both IVPB and IVP administration cohorts. Based on the Naranjo algorithm, all IVPB and IVP infusion site reactions were classified as possible or doubtful. Additional safety endpoints included bradycardia, hypotension, or sedation attributable to valproate sodium administration. Similar safety profiles were observed, including valproate-associated bradycardia, hypotension, and sedation events. All safety events were further classified as possible or doubtful by the Naranjo algorithm. Time from pharmacist verification to valproate administration was also collected. The mean time from pharmacist order verification to valproate administration was significantly faster in the IVP cohort compared to the IVPB cohort.

Conclusion

IVP valproate administration may be considered safe, allowing for more optimal clinical and operational outcomes in the acute care setting.
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Metadata
Title
Safety of Intravenous Push Valproate Compared with Intravenous Piggyback at a Tertiary Academic Medical Center
Authors
Felicia Y. Wang
Kevin C. McLaughlin
Michael J. Schontz
Jeremy R. DeGrado
Robert E. Dannemiller
Publication date
16-02-2024
Publisher
Springer International Publishing
Published in
Clinical Drug Investigation / Issue 3/2024
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-024-01349-z

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