A nurse is teaching a client newly prescribed topiramate for… | MyMerci
Medical Emergencies PA
Question

A nurse is teaching a client newly prescribed topiramate for migraine prophylaxis. Which set of self-care instructions is most important?

Explanation
Correct (2): Topiramate inhibits carbonic anhydrase, causing metabolic acidosis, increased risk of calcium phosphate kidney stones, and paresthesias (tingling in fingers/toes). Cognitive side effects ("dopamax") include word-finding difficulty and slowed thinking. Anorexia and weight loss are common. Adequate hydration (2-3 L/day) reduces stone risk. (1,3,4) Irrelevant dietary advice.

In-depth explanation

Memory Tip Topiramate = "Topa-MAX side effects" — kidney stones, slowness, sensation (paresthesia), slim (weight loss). CPG Avoid in clients with kidney stone history; check baseline bicarbonate.

Clinical scenario

Scenario 38-year-old female starting topiramate 25 mg PO daily titrating to 100 mg/day for chronic migraine prophylaxis. Receiving outpatient teaching.

Key concepts

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For study reference only. Always follow current clinical guidelines and your institution’s protocols.