Garris Shauna S, Oles Karen S
Department of Pharmacy, Medical University of South Carolina, Charleston, SC, USA.
Ann Pharmacother. 2005 Mar;39(3):424-6. doi: 10.1345/aph.1E437. Epub 2005 Feb 8.
Topiramate is an antiepileptic medication with multiple pharmacologic effects, including inhibition of carbonic anhydrase activity. It is associated with metabolic acidosis in both children and adults.
To evaluate the incidence and magnitude of the effect of topiramate on serum bicarbonate concentrations in an adult population.
This was a retrospective cohort study. Data were evaluated to assess the relationship between serum bicarbonate concentrations before and during topiramate therapy.
Fifty-four patients (40 females) with a mean age of 47.6 years (range 19-89) were included in the study. Mean +/- SD serum bicarbonate concentrations before and during topiramate therapy were 26.8 +/- 2.9 mEq/L (range 21-36) and 21.7 +/- 3.6 mEq/L (range 13-29), respectively, with a mean difference of 5.1 (95% CI 3.7 to 6.5; p < 0.001). Twenty-six patients (48%) had low serum bicarbonate concentrations while on topiramate, with a mean concentration of 18.8 mEq/L (range 13-21).
Topiramate was associated with metabolic acidosis in 48% of the patients studied, which did not result in clinically significant problems.
托吡酯是一种具有多种药理作用的抗癫痫药物，包括抑制碳酸酐酶活性。它在儿童和成人中均与代谢性酸中毒有关。
评估托吡酯对成年人群血清碳酸氢盐浓度影响的发生率和程度。
这是一项回顾性队列研究。对数据进行评估以评估托吡酯治疗前和治疗期间血清碳酸氢盐浓度之间的关系。
54例患者（40例女性）纳入研究，平均年龄47.6岁（范围19 - 89岁）。托吡酯治疗前和治疗期间血清碳酸氢盐平均±标准差浓度分别为26.8±2.9 mEq/L（范围21 - 36）和21.7±3.6 mEq/L（范围13 - 29），平均差值为5.1（95%CI 3.7至6.5；p < 0.001）。26例患者（48%）在服用托吡酯期间血清碳酸氢盐浓度较低，平均浓度为18.8 mEq/L（范围13 - 21）。
在所研究的患者中，48%的患者托吡酯与代谢性酸中毒有关，但未导致临床显著问题。
