Hey all, welcome back to the Real Life Pharmacology podcast. I am your host, pharmacist, Eric Christensen.

Thank you so much for listening today. As always, head over to real life pharmacology.com.

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going to start discussing topiramate, which is the drug of the day today. Brand name of this

medication is Topamax. Primary uses, I would say it's technically

classified as an anti-convulsant. I would say by far, probably the most common conditions I see

it used for. Definitely is migraine, probably the top of the list there.

Occasionally for seizures, also see it used in weight loss as well.

And if you remember, I've talked about, I think, a couple of weight loss drugs,

but Topiramate actually comes in combination as a brand name product called

Cusimia, and that's actually in combination with fentanymine. Mechanistically, this drug isn't

crazy well understood, and that's, you know, one of the reasons for that is it's got multiple possible mechanisms that it works through.

So one is that it helps to enhance GABA.

If you remember, GABA is an inhibitory neurotransmitter, so that may be one of the pathways

that it potentially helps with seizures and things like that. And same thing with blocking

voltage-gated sodium channels. That's also a purported mechanism there. And then it also

has carbonic anhydrase inhibitory action.

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