topiramate
PrintTrade Name(s): Topiragen; Topamax; Topiramate; Eprontia; Qudexy; Trokendi | |
Group 3: Reproductive Hazard | AHFS Class: Anticonvulsants, Miscellaneous |
Activity | Gloves | Gown | Eye/Face | Mask | Notes/Instructions |
Dispensing prepackaged formulations |
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Counting/Repackaging tablets and capsules | Recommended if pregnant, breast feeding, or trying to conceive | If risk of dust inhalation |
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Repackaging oral liquids | If risk of spill or splash | If risk of inhalation |
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Formulation | Gloves | Gown | Eye/Face | Mask | Notes/Instructions |
Tablet or capsule - from unit dose package | or Recommended if pregnant, breast feeding, or trying to conceive. |
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Liquid - oral or feeding tube | or Recommended if pregnant, breast feeding, or trying to conceive. | Recommended if pregnant, breast feeding, or trying to conceive. | If potential for splash, vomit or spit up. |
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Reference: NIOSH 2016, USP <800>
Type of Instance | Gloves | Gown | Mask | Eye/Face | Notes/Instructions |
Receiving undamaged HD shipping container |
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Receiving damaged HD shipping container | If container must be opened | If container must be opened | If container must be opened |
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Spill Cleanup | Large volume | Large volume |
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Reference: USP <800>
Hazardous Pharmaceutical | Trace Chemo | Biohazardous and Sharps |
1. Non-returnable hazardous, chemo and EPA regulated drugs. (Patient specific prescriptions, partially used blister packs, containers with more than 3% medication remaining) 2. Empty bottles or packaging of P-Listed drugs. (Warfarin, nicotine, epinephrine, nitroglycerin, physostigmine) 3. PPE with visible contamination from hazardous drug. | 1. Waste contaminated through contact with chemotherapeutic agents. (Empty vials, IV bags, syringes and tubing) 2. PPE worn while handling hazardous drugs with NO visible contamination. (Gowns, gloves and masks) 3. Used CSTD devices. | 1. All sharps capable of cutting or piercing the skin. (Needles/syringes, broken ampules, lancets) 2. Items contaminated with blood or other potentially infectious materials. (Tubing, bags or dressings containing blood, contaminated waste from isolation patients) |
Dosage Form | Ship to Institution or Pharmacy | Ship to Locations Outside of ODOC |
Tablets and Capsules |
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Liquid, Topical, and Transdermal |
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PPE | Standards |
Shoe Covers |
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Gowns |
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Gloves |
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Face Shields |
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Goggles |
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N95 Masks |
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Removal and Disposal |
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Reference: USP <800>
- Causes skin irritation [Warning Skin corrosion/irritation]
- Causes serious eye irritation [Warning Serious eye damage/eye irritation]
- May cause respiratory irritation [Warning Specific target organ toxicity, single exposure; Respiratory tract irritation]
- Suspected of damaging fertility or the unborn child [Warning Reproductive toxicity]
Only met the NIOSH criteria as a developmental and/or reproductive hazard
Topiramate is known for having several mechanisms of action including voltage-dependent sodium channels, GABA receptors, and glutamate receptors.6
Topiramate facilitates GABA-A receptor activity at non-benzodiazepine receptor sites and reduces glutamate activity in AMPA and kainate receptors. It is also proposed to reduce mesolimbic dopaminergic activity.3 As well, topiramate blocks the voltage-dependent sodium channels suppressing the spread of seizures.6Topiramate is known to be an inhibitor of carbonic anhydrase, however, this mechanism has been questioned to be its main mechanism of action. From its inhibitory activity towards carbonic anhydrase, topiramate is known to selectively inhibit the subtype II and IV. It is not ruled out the potential inhibition on other subtypes.8
Reference: Drug Bank