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

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

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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 Accent Lamp 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 Maestro AR/DSR1 T-Harness 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and VPA was discontinued.The same patient presented with VPA overdose eight months later after he continued to fill an outdated prescription.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.