Type II Renal Tubular Acidosis Secondary to Topiramate: A Review

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...

Full description

Saved in:
Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2018-11, Vol.10 (11), p.e3635
Main Authors: Sinha, Ankur, Oo, Phone, Asghar, Muhammad U, Cheema, Hira A, Mehta, Sanwal S, Leinwand, Joshua C, Janga, Kalyana
Format: Article
Language:English
Subjects:
Acidosis
Anticonvulsants
Convulsions & seizures
FDA approval
Internal Medicine
Kidney stones
Kidneys
Maimonides (Moses ben Maimon) (1135-1204)
Metabolism
Migraine
Nephrology
Urine
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.3635