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Combined, these effects can produce clinically significant cardiovascular stress, particularly in patients with pre-existing heart conditions or uncontrolled hypertension
GagginiMCarliFRossoCBuzzigoliEMariettiMDella LattaVet al
Lokrantz and coworkers [72] recently reported the case of an old woman taking VPA monotherapy for her partial epilepsy in whom a typical hyperammonaemic encephalopathy was precipitated by treatment for a urinary tract infection with pivmecillinam an antibiotic known to decrease the serum concentration of carnitine
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