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He, Q., Huang, X., Turel, O., et al

Among the proposed mechanisms for these effects, the reduction of toxic metabolites from fatty acids, especially LCAC under ischemic conditions, increased glucose oxidation during reperfusion, and consequently the reduction of lactate and H+ ion accumulation, resulting in the inhibition of acidosis in myocardial cells during ischemia, as well as the inhibition of harmful effects of free radicals released during reperfusion, are more prominently noted

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Gentle mixing by rolling the vial between the hands may be appropriate if settling has occurred, but aggressive agitation should be avoided

This older group of patients should be closely monitored during treatment with valproate for the development of acute liver injury with regular clinical assessments and serum liver test monitoring