Vega Damaris, Maalouf Naim M, Sakhaee Khashayar
University of Texas Southwestern Medical Center, Department of Internal Medicine and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, 5323 Harry Hines Boulevard, Dallas, TX 75390-8885, USA.
Expert Opin Drug Saf. 2007 Sep;6(5):547-57. doi: 10.1517/14740338.6.5.547.
Topiramate (TPM) is a neuromodulatory agent that was initially approved as an antiepileptic drug and is increasingly used in the treatment of a number of neurological and metabolic disorders. Among its various pharmacological actions, TPM has been shown to inhibit the activity of specific carbonic anhydrase enzymes in the kidney. This action is associated with the development of metabolic acidosis, hypocitraturia, hypercalciuria and elevated urine pH, leading to an increased risk of kidney stone disease. Despite the cautionary note in the package insert of TPM, the extent of these complications has not been fully explored. Few prescribing physicians are aware of these complications, underscoring the need for improved surveillance. Because the drug is among the most frequently prescribed agents in the US, more controlled studies are required to determine the prevalence of kidney stone disease among TPM users, and the optimal approach to prevent and treat nephrolithiasis in these individuals.
托吡酯（TPM）是一种神经调节药物，最初被批准用作抗癫痫药物，目前越来越多地用于治疗多种神经和代谢紊乱疾病。在其各种药理作用中，TPM已被证明可抑制肾脏中特定碳酸酐酶的活性。这种作用与代谢性酸中毒、低枸橼酸尿症、高钙尿症和尿液pH值升高的发生有关，从而导致肾结石疾病风险增加。尽管TPM的药品说明书中有警示说明，但这些并发症的程度尚未得到充分研究。很少有开处方的医生了解这些并发症，这突出表明需要加强监测。由于该药物是美国最常用的处方药之一，因此需要更多对照研究来确定TPM使用者中肾结石疾病的患病率，以及预防和治疗这些个体肾结石的最佳方法。
