Chronic impact of topiramate on acid-base balance and potassium in childhood

Belotti, Eva A.; Taddeo, Ilaria; Ragazzi, Monica; Pifferini, Rosanna; Simonetti, Giacomo D.; Bianchetti, Mario G.; Ramelli, Gian Paolo

doi:10.1016/j.ejpn.2009.11.004

Cited by 20 publications

(20 citation statements)

References 13 publications

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“…The mean decrease among these 21 patients was 4.7 ± 1.8 mEq/L, and the maximum was 10 mEq/L. In the study by Belotti et al, 6 plasma bicarbonate and potassium levels were on average lower in children and adolescents on long-term TPM therapy compared with controls. However, in patients on TPM, no statistically significant correlation of dose or blood concentration with either bicarbonate or potassium was observed.…”

Section: Background and Objectivementioning

confidence: 80%

“…6,8,15 Besides the TPM daily dose, the impact of TPM trough level was also explored. Similarly, Takeoka et al 15 investigated this influence.…”

Section: Discussionmentioning

confidence: 99%

“…However, in patients on TPM, no statistically significant correlation of dose or blood concentration with either bicarbonate or potassium was observed. 6 Furthermore, no association of TPM therapy duration, drug dose, or patient age with serum bicarbonate was detected in the adult population. 8 Although the influence of TPM on bicarbonate and potassium levels has been noted, the effect of some factors has not been fully quantified, especially in adult patients on long-term therapy.…”

Section: Background and Objectivementioning

confidence: 93%

“…4,5 Inhibition of CA may result in normal anion gap renal tubular acidosis (RTA) and change in potassium level. 6,7 Decrease of bicarbonate levels is often asymptomatic, but metabolic acidosis could also have significant clinical consequences. Metabolic acidosis may present as hyperventilation, fatigue, anorexia, nausea, delirium, or paresthesia.…”

Section: Background and Objectivementioning

confidence: 99%

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Effect of Long-term Topiramate Therapy on Serum Bicarbonate and Potassium Levels in Adult Epileptic Patients

et al. 2014

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Section: Background and Objectivementioning

confidence: 80%

“…6,8,15 Besides the TPM daily dose, the impact of TPM trough level was also explored. Similarly, Takeoka et al 15 investigated this influence.…”

Section: Discussionmentioning

confidence: 99%

Section: Background and Objectivementioning

confidence: 93%

Section: Background and Objectivementioning

confidence: 99%

See 2 more Smart Citations

Effect of Long-term Topiramate Therapy on Serum Bicarbonate and Potassium Levels in Adult Epileptic Patients

et al. 2014

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“…Hypokalemia is also common, with about 7% to 10% of patients taking topiramate having low serum potassium levels [22]. In another pediatric study, potassium levels were significantly lower in those using topiramate (3.7 versus 4.0 mmol/L; P<0.03) [23].…”

Section: Paresthesias Metabolic Acidosis and Hypokalemiamentioning

confidence: 98%

Safety of topiramate for treating migraines

Marmura

2014

Expert Opinion on Drug Safety

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Impact of adolescents’ binge drinking on blood chemistry

Pistritto,

Schera,

Vassilopoulou

et al. 2024

Eur J Pediatr

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Adolescent binge drinking is increasingly common. This study investigates the anomalies in glucose, sodium, calcium, potassium, and acid–base homeostasis induced by binge drinking in adolescents. The records of teenagers who sought medical attention for binge drinking (ethanol level ≥ 0.80 g/L) at the Pediatric Emergency Department, Ca’ Granda Ospedale Maggiore Policlinico, Milan (Italy), spanning the years 2013 to 2023 were retrospectively analyzed. For this analysis, cases were selected if documented blood chemistry encompassed sodium, potassium, total calcium, glucose, acid–base balance, and lactic acid (only for those with metabolic acidosis). Included were 173 adolescents (female-to-male ratio 0.94), 13.2 to 18.4, median 16.4 years of age. Hypoglycemia (≤ 3.3 mmol/L; N = 1, 0.6%), hyponatremia (≤ 134 mmol/L; N = 7, 4.0%), hypernatremia (≥ 146 mmol/L; N = 3, 1.7%), hypocalcemia (≤ 2.19 mmol/L; N = 0) hypercalcemia (≥ 2.61 mmol/L; N = 0), and hyperkalemia (≥ 5.1 mmol/L; N = 0) were infrequent. Acute respiratory acidosis (pCO2 ≥ 46 mm Hg; pH < 7.40; N = 101, 58%) was the most common acid–base imbalance, followed by respiratory alkalosis (pCO2 ≤ 34 mm Hg; pH > 7.40; N = 10, 5.6%), and metabolic acidosis (HCO3- ≤ 19 mmol/L, pH < 7.40; N = 9, 5.2%). The lactic acid level was increased (≥ 2.1 mmol/L) in all cases with metabolic acidosis. Metabolic alkalosis (HCO3- ≥ 28 mmol/L, pH > 7.40) never occurred. Hypokalemia (≤ 3.4 mmol/L; N = 56, 32%) was prevalent, particularly in adolescents with normal acid–base equilibrium or metabolic acidosis, rather than respiratory acidosis or alkalosis.Conclusion: Adolescents who engage in binge drinking often experience a disrupted acid–base balance and hypokalemia, while glucose, sodium and calcium levels are rarely affected. What is known?• Binge drinking is becoming increasingly common among adolescents.• Conflicting data regarding the type and prevalence of biochemical disorders induced by binge drinking are available in this age group. What is new?• Acute respiratory acidosis is prevalent in adolescents with binge drinking, whereas respiratory alkalosis, metabolic acidosis, and hypoglycemia are uncommon.• Hypokalemia develops frequently.

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Chronic impact of topiramate on acid-base balance and potassium in childhood

Cited by 20 publications

References 13 publications

Effect of Long-term Topiramate Therapy on Serum Bicarbonate and Potassium Levels in Adult Epileptic Patients

Effect of Long-term Topiramate Therapy on Serum Bicarbonate and Potassium Levels in Adult Epileptic Patients

Safety of topiramate for treating migraines

Impact of adolescents’ binge drinking on blood chemistry

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