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Deuteration has gained attention because of its potential to affect the pharmacokinetic and metabolic profiles of drugs [1]

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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

This restoration of the energy pipeline is absolutely critical for tissues with the highest metabolic demands, particularly the skeletal muscles and the myocardium