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Type II Renal Tubular Acidosis Secondary to Topiramate: A Review. | LitMetric

AI Article Synopsis

  • Topiramate (TMP) is an anticonvulsant used for seizure disorders and migraine prevention, but it can cause metabolic acidosis due to its effect on kidney function.
  • TMP inhibits carbonic anhydrase, leading to various symptoms like electrolyte imbalances, mental status changes, and respiratory issues.
  • There is no definitive way to prevent metabolic acidosis in patients on TMP, so doctors should exercise caution prescribing it to those with kidney issues or other health complications.

Article Abstract

Topiramate (TMP) is a broad-spectrum anticonvulsant drug used to treat a wide variety of seizure disorders, for migraine prophylaxis, and for many other indications. An important side effect of TMP is metabolic acidosis, which is mediated by renal tubular defects. TMP inhibits carbonic anhydrase, an enzyme that is necessary for acid handling in the proximal renal tubule. Patients can present with asymptomatic serum electrolyte derangements, acute change in mental status, hyperventilation, cardiac arrhythmias, or other sequelae of metabolic acidosis and associated respiratory compensation. If taken chronically, TMP can cause renal stone formation, bone mineralization defects, and several other effects secondary to changes in serum and urine pH and electrolytes. There is no well-studied way to prevent metabolic acidosis in patients taking TMP, but physicians should be vigilant when prescribing this drug to patients with the history of renal diseases and other comorbidities, and aware of this potential etiology of metabolic acidosis. We present a literature review of the underlying mechanisms involved in the development of renal tubular acidosis secondary to TMP and its clinical consequences.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351003PMC
http://dx.doi.org/10.7759/cureus.3635DOI Listing

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