Acetazolamide-Induced Nephrolithiasis in Idiopathic Intracranial Hypertension Patients

Au, Johnathan N.; Waslo, Carin S.; McGwin, Gerald; Huisingh, Carrie; Tanne, Emanuel

doi:10.1097/wno.0000000000000330

Cited by 8 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Table 1 summarizes the particularly significant adverse effects of AEDs in patients with SMID. Among others, urolithiasis is a well known complication due to TPM, ZNS, PHT and AZA [17][18][19][20]. In this study, CT im- PHT or AZA, and in 10 of 50 patients not taking the above AEDs.…”

Section: Discussionmentioning

confidence: 72%

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Saito¹,

Hirabayashi²,

Kita³

et al. 2020

E&S

View full text Add to dashboard Cite

To descr ibe the potentially ser ious adver se effects of antiepileptic dr ugs (AEDs) in individuals with severe motor and intellectual disabilities (SMID) and to improve the quality of drug treatment for these patients. Methods: The data of 99 SMID patients with epilepsy staying at an institute for mor e than 1 year were retrospectively reviewed. Each patient was taking 3.4 ± 1.6 (range, 1-8) kinds of AEDs, and clinical seizures were still prevalent in 68 patients. Results: Discontinuation or dose r eduction of AEDs amelior ated agitation and/or sleep disturbance, somnolence, vomiting, appetite loss, and stridor in the corresponding patients, and additionally resolved serious gastrointestinal or cardiorespiratory problems in three patients whose clinical courses were detailed. Patient 1 manifested aerophagia-related chronic distension of the abdomen causing mechanical ileus, requiring repeated intestinal resection. The abdominal distension improved significantly after discontinuation of acetazolamide. Patient 2 experienced progressive motor deterioration during young adulthood, with simultaneous sudden elevation in blood phenytoin level. Although motor disability persisted, resolution of hypoventilation was noted after cessation of phenytoin. Patients 3 had long-term use of carbamazepine and exhibited episodic bradycardia (heart rate as low as 25 bpm) that resolved after drug discontinuation. Conclusions: Patients with SMID sometimes fail to effectively ver balize subjective adver se effects of medications to healthcare providers. The chronic adverse effects of AEDs, including those described in this study, should be broadly evaluated for better patient management.

show abstract

Section: Discussionmentioning

confidence: 72%

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Saito¹,

Hirabayashi²,

Kita³

et al. 2020

E&S

View full text Add to dashboard Cite

show abstract

“…Some of the CAI's side effects such as paresthesia, fatigue and mild cognitive disturbance can be minimised by gradual titration of the dose and using the minimum effective dose if necessary by introducing combination therapy with diuretics [95]. However, CAI use carries a clear risk of nephrolithiasis, with acetazolamide reported to show an increase by 15% within 1.5 years after initial treatment, which was not related to dosage [96]. A baseline renal ultrasound scan should therefore be performed before commencing CAI therapy and annual monitoring may reduce acute presentation with ureteric obstruction from urolithiasis [45•].…”

Section: Carbonic Anhydrase Inhibitormentioning

confidence: 99%

Treatment Updates for Neuromuscular Channelopathies

Jitpimolmard

Matthews

Fialho

2020

Curr Treat Options Neurol

View full text Add to dashboard Cite

Purpose of review This article aims to review the current and upcoming treatment options of primary muscle channelopathies including the non-dystrophic myotonias and periodic paralyses. Recent findings The efficacy of mexiletine in the treatment of myotonia is now supported by two randomised placebo-controlled trials, one of which utilised a novel aggregated n-of-1 design. This has resulted in licencing of the drug via orphan drug status. There is also good evidence that mexiletine is well tolerated and safe in this patient group without the need for intensive monitoring. A range of alternative antimyotonic treatment options include lamotrigine, carbamazepine and ranolazine exist with variable evidence base. In vitro studies have shown insight into reasons for treatment failure of some medications with certain genotypes opening the era of mutation-specific therapy such as use of flecainide. In the periodic paralyses, the ability of MRI to distinguish between reversible oedema and irreversible fatty replacement makes it an increasingly useful tool to guide and assess pharmacological treatment. Unfortunately, the striking efficacy of bumetanide in hypokalaemic periodic paralysis animal models was not replicated in a recent pilot study in humans. Summary The treatment of skeletal muscle channelopathies combines dietary and lifestyle advice together with pharmacological interventions. The rarity of these conditions remains a barrier for clinical studies but the example of the aggregated n-of-1 trial of mexiletine shows that innovative trial design can overcome these hurdles. Further research is required to test efficacy of drugs shown to have promising characteristics in preclinical experiments such as safinamide, riluzule and magnesium for myotonia or bumetanide for hypokalaemic periodic paralysis.

show abstract

“…Another was published in the Journal of Women’s Health concerning the association between weight gain and the appearance of new visual field defects (30). A recent study examined the association between acetazolamide and nephrolithiasis (31). Again, a registry of this kind is useful as IIH is a relatively rare disease affecting only about 1 in 100,000 people.…”

Section: Examples Of Registries Relevant To Neuro-ophthalmologymentioning

confidence: 99%

Research Registries: A Tool to Advance Understanding of Rare Neuro-Ophthalmic Diseases

Blankshain

Moss

2016

Journal of Neuro-Ophthalmology

View full text Add to dashboard Cite

Background Medical research registries (MRR) are organized systems used to collect, store and analyze patient information. They are important tools for medical research with particular application to the study of rare diseases, including those seen in neuro-ophthalmic practice. Evidence Acquisition Evidence for this review was gathered from the writers’ experiences creating a comprehensive neuro-ophthalmology registry and review of the literature. Results MRR are typically observational and prospective databases of de-identified patient information. The structure is flexible and can accommodate a focus on specific diseases or treatments, surveillance of patient populations, physician quality improvement, or recruitment for future studies. They are particularly useful for the study of rare diseases. They can be integrated into the hierarchy of medical research at many levels provided their construction is well organized and they have several key characteristics including an easily manipulated database, comprehensive information on carefully selected patients and comply with human subjects regulations. MRR pertinent to neuro-ophthalmology include the UIC neuro-ophthalmology registry, Susac Syndrome Registry, Intracranial Hypertension Registry as well as larger scale patient outcome registries being developed by professional societies. Conclusion Medical research registries have a variety of forms and applications. With careful planning and clear goals, they are flexible and powerful research tools that can support multiple different study designs, and through this have the potential to advance understanding and care of neuro-ophthalmic diseases.

show abstract

Acetazolamide-Induced Nephrolithiasis in Idiopathic Intracranial Hypertension Patients

Cited by 8 publications

References 20 publications

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Adverse effects of antiepileptics potentially serious in individuals with severe motor and intellectual disabilities

Treatment Updates for Neuromuscular Channelopathies

Research Registries: A Tool to Advance Understanding of Rare Neuro-Ophthalmic Diseases

Contact Info

Product

Resources

About