Continued Use of Zonisamide Following Development of Renal Calculi

Richards, Karen C.; Smith, Michael C.; Verma, Amit

doi:10.21236/ada425098

Cited by 2 publications

(11 citation statements)

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“…The same group also treated a patient on ZNS after a stone with increased fluid intake and drug continuation. The patient had no recurrence up to 42 months of follow up . In contrast, a patient reported by Lamb et al treated with increased fluid intake and potassium citrate after a stone event on high‐dose TPM (1000 mg/day) had a stone recurrence at 2 years of follow up .…”

Section: Expert Commentarymentioning

confidence: 78%

“…Although a risk factor for calcium containing stones, it is reasonable to continue treatment after discussion if the benefits of treatment outweigh the risks of recurrent stones. Prior case reports that continued the use of ZNS in epileptic patients with doses ranging from 400 to 600 mg/day and follow up to 45 months did not result in recurrence of calculi …”

Section: Expert Commentarymentioning

confidence: 91%

“…Evaluation of urinary parameters on citrate revealed complete correction of hypocitraturia without an increase in calcium phosphate supersaturation . A patient following a stone on ZNS was continued on the drug with the addition of calcitrate and had no stone recurrences up to 45 months of follow up . The same group also treated a patient on ZNS after a stone with increased fluid intake and drug continuation.…”

Section: Expert Commentarymentioning

confidence: 94%

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The Risk and Management of Kidney Stones From the Use of Topiramate and Zonisamide in Migraine and Idiopathic Intracranial Hypertension

et al. 2014

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Section: Expert Commentarymentioning

confidence: 78%

Section: Expert Commentarymentioning

confidence: 91%

Section: Expert Commentarymentioning

confidence: 94%

See 1 more Smart Citation

The Risk and Management of Kidney Stones From the Use of Topiramate and Zonisamide in Migraine and Idiopathic Intracranial Hypertension

et al. 2014

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“…In the present case, urine crystals were unique and resembled crystals identified in humans treated with sulfamethoxazole . Two other sulfanilamide anticonvulsants used in humans, acetazolamide and topiramate, also have been linked with crystalluria and urolith formation associated with inhibition of carbonic anhydrase . Urolith formation secondary to acetazolamide and topiramate is attributed to urine alkalinization and precipitation of calcium‐integrated deposits (eg, calcium oxalate, calcium phosphate).…”

mentioning

confidence: 99%

“…Urolith formation secondary to acetazolamide and topiramate is attributed to urine alkalinization and precipitation of calcium‐integrated deposits (eg, calcium oxalate, calcium phosphate). However, comparable inhibitory potency of zonisamide on carbonic anhydrase is estimated as only 0.01 that of acetazolamide . Whether or not the crystalluria associated with acute marked increase in ALT activity can function as a means of surveillance for rare zonisamide hepatotoxicity in dogs remains to be determined.…”

mentioning

confidence: 99%

Apparent Acute IdiosyncraticHepaticNecrosis Associated withZonisamide Administration in a Dog

Miller

Randolph

Lepherd

et al. 2011

Veterinary Internal Medicne

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A 4-year-old, 6.5-kg, castrated male Boston Terrier was referred to the Cornell University Hospital for Animals for evaluation of seizures. Seizure activity was characterized by unconsciousness, tonic-clonic limb movements, and hypersalivation, with each seizure lasting approximately 1 minute. Three seizures had occurred during the 24 hours preceding presentation. Otherwise, the dog had been clinically healthy. No drugs were administered and toxin exposure was unlikely. Laboratory assessment completed by the referring veterinarian included CBC and serum biochemistry (sodium, potassium, chloride, total protein, albumin, globulin, BUN, creatinine, glucose, calcium, phosphorus, total bilirubin, and cholesterol concentrations; alkaline phosphatase [ALP], alanine aminotransferase [ALT], and amylase activities). Results disclosed eosinopenia (0.09 9 10 3 cells/lL; reference range 0.1-1.49 9 10 3 /lL) and mildly increased ALT activity (124 U/L; reference range, 10-100 U/L).On presentation, the dog was bright and alert with modest upper airway stridor attributable to brachycephalic conformation. Neurologic examination demonstrated decreased menace OD and equivocal cervical pain. h revealed multifocal, asymmetrical ill-defined intra-axial hyperintense areas in the cerebral cortex; these regions were slightly hyperintense to brain on T2-weighted images and fluid attenuated inversion recovery, but lacked contrast enhancement. A linear intra-axial lesion with the same signal intensity as cerebrospinal fluid (CSF) that did not contrast enhance was noted within spinal cord parenchyma at C1 and C2, consistent with mild syringohydromyelia.The CSF collected from the lumbosacral subarachnoid space was colorless and clear with normal nucleated cell count (3/lL; reference range, <5/lL) and total protein concentration (21 mg/dL; reference range, <45 mg/dL); cytologic examination disclosed 63% small lymphocytes and 37% macrophages. Collective findings were interpreted as changes secondary to the recent seizure activity and mild syringohydromyelia. The dog was prescribed the anticonvulsant zonisamide i (7.7 mg/kg PO q12h) for presumed idiopathic epilepsy.After 10 days of zonisamide administration, the dog was presented again for inappetence and vomiting. No seizure activity had occurred since instituting zonisamide. Results of CBC and serum biochemistry disclosed lymphopenia (0.5 9 10 3 /lL; reference range, 0.9-4.7 9 10 3 /lL), eosinopenia (0.0 9 10 3 /lL), mild thrombocytopenia (176 9 10 3 /lL; reference range, 186-545 9 10 3 /lL) with platelet clumps, few acanthocytes and keratocytes, marked increases in activities of ALT (16328 U/L) and aspartate aminotransferase (AST; 5908 U/L; reference range, 16-50 U/L), modest increases in activities of ALP (354 U/L; reference range, 12-122 U/L) and gamma-glutamyl transferase (GGT, 61 U/L; reference range, 0-10 U/L), and hyperbilirubinemia (2.3 mg/dL; reference range, 0-0.3 mg/ dL). Urine was concentrated (specific gravity 1.050) with bilirubinuria, 2+ proteinuria, pH 7.5, and sediment demonst...

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Continued Use of Zonisamide Following Development of Renal Calculi

Cited by 2 publications

References 0 publications

The Risk and Management of Kidney Stones From the Use of Topiramate and Zonisamide in Migraine and Idiopathic Intracranial Hypertension

The Risk and Management of Kidney Stones From the Use of Topiramate and Zonisamide in Migraine and Idiopathic Intracranial Hypertension

Apparent Acute IdiosyncraticHepaticNecrosis Associated withZonisamide Administration in a Dog

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