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PEA is one of the most abundant endocannabinoids in the gut and is thought to play a key role in gut-brain axis
Audrey Calderwood, MD, director of the GI Cancer Risk and Prevention Clinic at the Dartmouth Geisel School of Medicine in Hanover, New Hampshire, and an ASGE member, notes however that a low-residue diet may be an option instead of a liquid diet
Therefore increased monitoring of valproate and concomitant drug concentrations and dosage adjustment are indicated whenever enzyme-inducing or inhibiting drugs are introduced or withdrawn (7.1) Aspirin, carbapenem antibiotics, estrogen-containing hormonal contraceptives: Monitoring of valproate concentrations is recommended (7.1) Co-administration of valproate can affect the pharmacokinetics of other drugs (e.g., diazepam, ethosuximide, lamotrigine, phenytoin) by inhibiting their metabolism or protein binding displacement (7.2) Patients stabilized on rufinamide should begin valproate therapy at a low dose, and titrate to clinically effective dose (7.2) Dosage adjustment of amitriptyline/nortriptyline, propofol, warfarin, and zidovudine may be necessary if used concomitantly with Valproic acid (7.2) Topiramate: Hyperammonemia and encephalopathy (5.10, 7.3) Use In Specific Populations Pregnancy: Valproic acid can cause congenital malformations including neural tube defects, decreased IQ, and neurodevelopmental disorders (5.2, 5.3, 8.1) Pediatric: Children under the age of two years are at considerably higher risk of fatal hepatotoxicity (5.1, 8.4) Geriatric: Reduce starting dose
10.1111/j.1365-2362.2009.02190.x
Individuals under physical or mental stress, such as those recovering from surgery or dealing with chronic illness
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