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These polymers are derived from polystyrene by the addition of sulfonate functional groups. Sodium polystyrene sulfonate was approved for medical use in the United States in 1958. [1] A polystyrene sulfonate was developed in the 2000s to treat Clostridioides difficile associated diarrhea under the name Tolevamer, [2] but it was never marketed.
Potassium binders are medications that bind potassium ions in the gastrointestinal tract, thereby preventing its intestinal absorption. This category formerly consisted solely of polystyrene sulfonate, a polyanionic resin attached to a cation, administered either orally or by retention enema to patients who are at risk of developing hyperkalaemia (abnormal high serum potassium levels).
These methods include polystyrene microspheres, nanoparticles, and solid foams. In the biomedical engineering field, these methods assist researchers in drug delivery, diagnostics, and imaging strategies. [1] [2] A common group of medication that utilizes a combination of polystyrene and sulfonate functional groups are polystyrene sulfonates. [3]
Tolevamer was designed to bind the enterotoxins of Clostridioides difficile.Since it has no antibiotic properties, it does not harm the gut flora.Early studies used the sodium salt, but it was soon replaced with the potassium sodium salt to prevent hypokalaemia, which is often associated with diarrhea.
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Patiromer was generally well tolerated in studies. Side effects that occurred in more than 2% of patients included in clinical trials were mainly gastro-intestinal problems such as constipation, diarrhea, nausea, and flatulence, and also hypomagnesemia (low levels of magnesium in the blood) in 5% of patients, because patiromer binds magnesium in the gut as well.
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However, high quality evidence to demonstrate the effectiveness of sodium polystyrene are lacking, and use of sodium polystyrene sulfonate, particularly with high sorbitol content, is uncommonly but convincingly associated with colonic necrosis. [42] [43] [44] There are no systematic studies (>6 months) looking at the long-term safety of this ...