Which adverse effect profile is most characteristic of topiramate?

• A Weight gain, gingival hyperplasia, and hirsutism
• B Visual field constriction, sedation, and behavioral disturbance
• C Weight loss, paresthesias, nephrolithiasis, and word-finding difficulty ✓
• D Stevens-Johnson syndrome restricted to HLA-B*1502 carriers

Explanation

Topiramate inhibits carbonic anhydrase, producing paresthesias, metabolic acidosis, alkaline urine, and calcium phosphate nephrolithiasis. It also causes anorexia with weight loss and prominent cognitive effects, especially word-finding difficulty and psychomotor slowing. Option B describes vigabatrin, whose hallmark toxicity is concentric visual field constriction. Option D relates to carbamazepine, and option A fits valproate and phenytoin.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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