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(Ammonia is normally processed by the liver and transformed into another waste product called urea

(I've described my distaste for the entire concept of antidotes in a previous column, arguing that the term leads to muddy thinking and failure to weigh critically whether or not a specific intervention is indicated in individual cases.) Dr Juurlink is careful to point out that the vast majority of VPA overdose cases will not need a carbapenem because most patients improve with routine treatment

however, it should be emphasised that this model is hypothetical and requires further evaluation before being translated to practice (Figures 1 and 2)

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