Comment administrer des gouttelettes Depakine à un enfant de 2 ans?

e and bioavailability of valproic acid and its sodium salt from rectal dosage forms. Eur J Clin Pharmacol 1980;17:309-15.

La première option consiste à prendre une seringue de 10 ml; Remplissez cette moitié avec une boisson liquide au bon goût et ajoutez-y les gouttes de Depakine. Le tout est inséré dans la bouche de l'enfant et la bouche est maintenue fermée pendant quelques minutes.

Une deuxième possibilité est l'utilisation de suppositoires. Ici, la question se pose, après l'enregistrement du valproate par voie rectale. Voir une petite anthologie de ce que l'on peut trouver dans la littérature à ce sujet.

 1. Absorption rate and bioavailability of rectal valproic acid and its sodium salt from rectal dosage forms

Rectal and oral absorption of valproic acid and its sodium salt by man were compared to explore the possibility of rectal administration of the drug. The plasma concentration of valproic acid was measured by gas chromatography after a single oral dose of sodium valproate 600 mg, and after single rectal doses of sodium valproate 600 mg and valproic acid 520 mg, in a cross-over study in 7 volunteers. The rectal dosage forms included fatty suppositories and aqueous solutions. Compared with oral administration, rectal absorption of sodium valproate from an aqueous micro-enema was fast and complete. The free acid was absorbed more rapidly from fatty suppositories than was the sodium salt. The absorption rate from the rectum increased with the dose of valproic acid. Both findings are consistent with a diffusion — absorption mechanism based on the pH-partition hypothesis. Differences in the chemical composition of the fatty suppository base were not reflected in differences in absorption rate and relative bioavailability. No essential difference in absorption rate was observed if volunteers remained lying or sitting during the experiment. Rectal dosing with valproic acid 520 mg dissolved in 4 ml suppositories, twice a day resulted in steady-state plasma concentrations of 50 to 100 µg · ml⁻¹, within the therapeutic range.

2. Treatment of status epilepticus in children with rectal sodium valproate 

Our data indicate that valproic acid is effective in the treatment of intractable status epilepticus when administered rectally in children. We recommend a loading dose of 20 mg/kg to attain plasma levels of approximately 50 mg/l 

Het is dus duidelijk dat Na valproaat (nog beter het zuur) rectaal wordt geabsorbeerd. indien overgeschakeld wordt op zetpillen zal de therapie met de arts moeten worden besproken teneinde de dosis van de zetpillen te bepalen alsook het tijdstip van toediening en het aantal toe te dienen zetpillen per dag .