Department of Pediatrics, Bellinzona and Mendrisio, and University of Bern, Switzerland.
Eur J Paediatr Neurol. 2010 Sep;14(5):445-8. doi: 10.1016/j.ejpn.2009.11.004. Epub 2009 Dec 16.
Topiramate, which is commonly prescribed for seizure disorders and migraine prophylaxis, sometimes causes metabolic acidosis and hypokalemia. Since the effects of topiramate on acid-base balance and potassium levels have not been well explored in children, acid-base balance, anion gap and potassium were assessed in 24 patients (8 females and 16 males) aged between 4.6 and 19 years on topiramate for more than 12 months and in an age-matched control group. Plasma bicarbonate (21.7 versus 23.4 mmol/L; P<0.03), carbon dioxide pressure (39.7 versus 43.2mm Hg; P<0.05), and potassium (3.7 versus 4.0 mmol/L; P<0.03) were on the average lower and chloride (109 versus 107 mmol/L; P<0.03) higher in patients treated with topiramate than in controls. Blood pH, plasma sodium and the anion gap were similar in patients on topiramate and in controls. In patients on topiramate no significant correlation was observed between the dosage of this agent and plasma bicarbonate or potassium as well as between topiramate blood level and the mentioned electrolytes. In conclusion long-term topiramate treatment is associated with a mild, statistically significant tendency towards compensated normal anion gap metabolic acidosis and hypokalemia.
托吡酯常用于治疗癫痫和偏头痛的预防，有时会引起代谢性酸中毒和低钾血症。由于托吡酯对儿童酸碱平衡和钾水平的影响尚未得到充分研究，因此评估了 24 名年龄在 4.6 至 19 岁之间、接受托吡酯治疗超过 12 个月的患者（8 名女性和 16 名男性）以及年龄匹配的对照组的酸碱平衡、阴离子间隙和钾水平。与对照组相比，接受托吡酯治疗的患者的血浆碳酸氢盐（21.7 对 23.4mmol/L；P<0.03）、二氧化碳分压（39.7 对 43.2mmHg；P<0.05）和钾（3.7 对 4.0mmol/L；P<0.03）平均较低，而氯（109 对 107mmol/L；P<0.03）较高。接受托吡酯治疗的患者和对照组的血液 pH 值、血浆钠和阴离子间隙相似。在接受托吡酯治疗的患者中，该药物的剂量与血浆碳酸氢盐或钾以及托吡酯的血药水平与上述电解质之间均未观察到显著相关性。总之，长期使用托吡酯治疗与轻度、具有统计学意义的正常阴离子间隙代谢性酸中毒和低钾血症有关。
