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ZonisamideAka: Zonegran

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  1. Indications
    1. Adjunctive management of partial Seizures
    2. Add to primary antiepileptic regimens
      1. Carbamazepine
      2. Phenytoin
      3. Valproate
    3. Other potential uses currently being researched
      1. Myoclonic Seizures
      2. Infantile Spasm
      3. Atypical Absence Seizure
      4. Generalized Tonic Clonic Seizures
  2. Pharmacology
    1. Weak Carbonic Anhydrase Inhibitor
    2. Sulfonamide that blocks sodium and calcium channels
      1. Increases Dopaminergic transmission
      2. Increases serotonergic transmission
    3. Metabolized by CYP3A4
    4. Half-Life: 60 hours
  3. Drug Interactions
    1. Increased Zonisamide clearance with CYP3A4 inducers
      1. Phenytoin
      2. Carbamazepine
      3. Phenobarbital
    2. Concurrent Carbonic Anhydrase Inhibitor (Topamax)
      1. Increased Nephrolithiasis risk
  4. Adverse effects
    1. Dizziness
    2. Ataxia
    3. Somnolence
    4. Nausea
    5. Anorexia
    6. Abdominal Pain
    7. Insomnia
    8. Impaired cognition
      1. Confusion
      2. Decreased concentration
      3. Speech problems
    9. Psychosis
    10. Nephrolithiasis
    11. Rash
    12. Stevens Johnson Syndrome
    13. Toxic epidermal necrolysis
    14. Childhood Adverse Effects
      1. Oligohydrosis
      2. Hyperthermia (and Heat Stroke)
  5. Contraindications
    1. Sulfonamide allergy
    2. Pregnancy (Teratogenic in animals)
  6. Dosing: Adults
    1. Initial: 100 mg PO qd
    2. Increase: 100 mg every two weeks as needed
    3. Maximum: 600 mg/day divided qd-bid
    4. Caution: Increase more slowly in renal insufficiency
  7. References
    1. Padgett (1997) Epilepsia 38(suppl 8):107
    2. Schmidt (1993) {a 14228} Res 15:67
    3. Wallace (1998) {a 14228} Res 29:147
    4. Yagi (2000) Neurology 54(Suppl 3):A195
    5. Yanai (1999) Brain Dev 21:157
    6. (2000) Med Lett Drugs Ther 42(1089):93

zonisamide (C0078844)

Definition (NCI)A sulfonamide derivative with an anticonvulsant property. The exact mechanism of action remains to be elucidated. Zonisamide appears to block sodium and calcium channels, thereby stabilizing neuronal membranes and suppressing neuronal hypersynchronization. Although zonisamide shows affinity for the gamma-aminobutyric acid (GABA) /benzodiazepine receptor ionophore complex, it does not potentiate the synaptic activity of GABA. In addition, this agent also facilitates both dopaminergic and serotonergic neurotransmission.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
Englishzonisamide, ZONISAMIDE PREPARATION
Spanishzonisamida
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Zonegran (C0876224)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
EnglishElan brand of zonisamide, Zonegran
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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