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

Jovanović, Marija; Sokić, Dragoslav; Grabnar, Iztok; Prostran, Milica; Obrenović, Radmila; Vučićević, Katarina; Miljković, Branislava

doi:10.1177/1060028014534397

Cited by 9 publications

(11 citation statements)

References 21 publications

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“…TPM use has been associated with hyperchloremic normal anion gap metabolic acidosis without regard to dose; this is attributed to mixed renal tubular acidosis ( 8 ). The higher tendency of such acidosis to appear by 5 or more years of therapy ( 9 ) was borne out in our patient. Therefore, it is imperative to identify risk factors that may predispose patients to hyperchloremic metabolic acidosis while taking TPM.…”

Section: Discussionsupporting

confidence: 54%

Topiramate as a rare cause of reversible Fanconi syndrome and acute kidney injury: a case report and literature review

Meseeha

Attia²,

Kolade

2016

Journal of Community Hospital Internal Medicine Perspectives

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Topiramate (TPM) is a sulfa-derivative monosaccharide that has been used for multiple indications in the last several years. We describe a 53-year-old woman with known chronic kidney disease stage 2 and baseline creatinine of 1 mg/dL who developed acute kidney injury and proximal renal tubular dysfunction while on TPM for depression. The Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship (score of 6) between TPM and acute kidney injury as well as proximal tubular dysfunction; these renal conditions resolved on withdrawal of TPM. To our knowledge, this is the first report of such a scenario. Patients receiving TPM therapy should be closely monitored for evidence of kidney dysfunction and electrolyte abnormalities.

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Section: Discussionsupporting

confidence: 54%

Topiramate as a rare cause of reversible Fanconi syndrome and acute kidney injury: a case report and literature review

Meseeha

Attia²,

Kolade

2016

Journal of Community Hospital Internal Medicine Perspectives

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“…Weight loss from appetite reduction is a side effect and may be desired, in patients who are overweight or obese . We recommend monitoring serum electrolytes and renal function twice a year as metabolic acidosis may occur . Oral bicarbonate supplementation may be initiated if serum bicarbonate is <20 mmol/L.…”

Section: Prophylactic Medications In Cvsmentioning

confidence: 99%

Guidelines on management of cyclic vomiting syndrome in adults by the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association

Venkatesan

Levinthal

Tarbell

et al. 2019

Neurogastroenterology Motil

122

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The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence‐based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework was used and a professional librarian performed the literature search. The expert committee included the President of the CVSA who brought a patient perspective into the deliberations. The committee makes recommendations for the prophylaxis of CVS, treatment of acute attacks, diagnosis, and overall management of CVS. The committee strongly recommends that adults with moderate‐to‐severe CVS receive a tricyclic antidepressant (TCA), such as amitriptyline, as a first‐line prophylactic medication and receive topiramate or aprepitant as alternate prophylactic medications. Zonisamide or levetiracetam and mitochondrial supplements (Coenzyme Q10, L‐carnitine, and riboflavin) are conditionally recommended as alternate prophylactic medications, either alone or concurrently with other prophylactic medications. For acute attacks, the committee conditionally recommends using serotonin antagonists, such as ondansetron, and/or triptans, such as sumatriptan or aprepitant to abort symptoms. Emergency department treatment is best achieved with the use of an individualized treatment protocol and shared with the care team (example provided). The committee recommended screening and treatment for comorbid conditions such as anxiety, depression, migraine headache, autonomic dysfunction, sleep disorders, and substance use with referral to appropriate allied health services as indicated. Techniques like meditation, relaxation, and biofeedback may be offered as complementary therapy to improve overall well‐being and patient care outcomes.

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“…Various isoforms of CA have been identified as therapeutic targets for several diseases, see Table 1 . Therefore, the design of isoform-specific inhibitors is studied for the development of new and improved treatments [ 6 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Non-Classical Inhibition of Carbonic Anhydrase

Lomelino

Supuran

McKenna

2016

IJMS

109

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Specific isoforms from the carbonic anhydrase (CA) family of zinc metalloenzymes have been associated with a variety of diseases. Isoform-specific carbonic anhydrase inhibitors (CAIs) are therefore a major focus of attention for specific disease treatments. Classical CAIs, primarily sulfonamide-based compounds and their bioisosteres, are examined as antiglaucoma, antiepileptic, antiobesity, antineuropathic pain and anticancer compounds. However, many sulfonamide compounds inhibit all CA isoforms nonspecifically, diluting drug effectiveness and causing undesired side effects due to off-target inhibition. In addition, a small but significant percentage of the general population cannot be treated with sulfonamide-based compounds due to a sulfa allergy. Therefore, CAIs must be developed that are not only isoform specific, but also non-classical, i.e. not based on sulfonamides, sulfamates, or sulfamides. This review covers the classes of non-classical CAIs and the recent advances in the development of isoform-specific inhibitors based on phenols, polyamines, coumarins and their derivatives.

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

Abstract: Results highlight the frequent occurrence of lower bicarbonate level associated with prolonged TPM therapy. Monitoring bicarbonate levels in patients on long-term TPM therapy might be useful.

Cited by 9 publications

References 21 publications

Topiramate as a rare cause of reversible Fanconi syndrome and acute kidney injury: a case report and literature review

Topiramate as a rare cause of reversible Fanconi syndrome and acute kidney injury: a case report and literature review

Guidelines on management of cyclic vomiting syndrome in adults by the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association

Non-Classical Inhibition of Carbonic Anhydrase

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