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If the patient is compos mentis, then no. Mohammad Dr. M A Al-Jubouri, MB ChB, MSc, EurClinChem, FRCP Edin, FRCPath Consultant Chemical Pathologist ________________________________ From: COLLINS MICHAEL (RM1) Norfolk and Norwich University Hospital <[log in to unmask]> To: [log in to unmask] Sent: Thursday, May 16, 2013 12:24 PM Subject: Re: Valproate monitoring in epilepsy - BNF Valproate monitoring in epilepsy - BNF Wouldn’t it be better to measure ammonia in long term valproate patients? Mike Collins BMS3 Biochemistry Automation Norfolk & Norwich University Hospital England [log in to unmask] http://www.nnuh.nhs.uk/ From:Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Hallworth Mike (RLZ) Sent: 16 May 2013 12:10 To: [log in to unmask] Subject: Valproate monitoring in epilepsy - BNF Hi all - just for information. The BNF used to dissuade people from routine valproate monitoring in epilepsy, but I recently noticed that they had changed the relevant section to read: "Sodium valproate has widespread metabolic effects and monitoring is essential" (see BNF 64, page 298). They meant LFT and FBC monitoring, but it wasn't at all clear from the context. I wrote to them about this, and am pleased to say that BNF 65 (March-Sept 2013) now says (bottom of page 302): "Sodium valproate has widespread metabolic effects and monitoring of liver function tests and full blood count is essential…. Plasma valproate concentrations are not a useful index of efficacy, therefore routine monitoring is unhelpful." Small victory - might be useful to some of you in restricting inappropriate requests. Cheers, Mike ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify the originator of the message. This footer also confirms that this email message has been scanned for the presence of computer viruses but this should not be relied upon as a guarantee that the contents are virus free. Any views expressed in this message are those of the individual sender, except where the sender specifies and with authority, states them to be the views of the Norfolk and Norwich University Hospitals NHS Foundation Trust. The information contained in this e-mail may be subject to public disclosure under the Freedom of Information Act 2000. Unless the information is legally exempt from disclosure, the confidentiality of this e-mail and your reply cannot be guaranteed ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/