조니사마이드

항경련제

조니사마이드는 벤즈이속사졸 유도체이자 설폰아마이드계 항경련제입니다. 수의학에서는 주로 개와 고양이의 난치성 특발성 간질에 대한 보조 요법 또는 단독 요법으로 사용됩니다. * **임상적 특징**: 페노바르비탈에 비해 간 대사 부담이 적어 간 독성을 피해야 하는 환자에게 선호되는 경우가 많습니다. * 소동물에서 유리한 약동학적 특성을 가지며, 반감기는 개에서 약 15시간(하루 2회 투여 가능), 고양이에서 약 33시간(하루 1회 투여 가능)입니다. * 사람과 달리 개에서는 표준 용량에서 선형 약동학을 보입니다.

작용 기전: The exact mechanism of action is multifactorial and not completely elucidated: * Blocks **voltage-gated sodium channels** and reduces transient inward currents → stabilizes neuronal membranes and suppresses neuronal hypersynchronization. * Inhibits **T-type voltage-gated calcium channels**. * Acts as a weak **carbonic anhydrase inhibitor**. * *Note*: Unlike diazepam or phenobarbital, it does **not** appear to potentiate GABAergic activity.

동물 종별 용량

Cats

Epilepsy (anecdotal) · 5 mg/kg PO every 12-24 hours · PO · q12-24h · Most commonly utilized anecdotal dose.
Refractory to phenobarbital · 5-10 mg/kg PO once daily · PO · q24h · Long half-life makes once daily dosing likely appropriate.
Epilepsy · 10-20 mg/kg PO once daily · PO · q24h
Epilepsy · 5-10 mg/kg · PO · q24h · Long-term · Longer half-life in cats allows for once-daily dosing.

Dogs

Refractory epilepsy (with phenobarbital) · 5-10 mg/kg PO q12h · PO · q12h · The high end of the dose range is needed when used in combination with phenobarbital due to microsomal enzyme induction.
Monotherapy · Initially at 5 mg/kg PO twice daily (q12h) · PO · q12h
Add-on with phenobarbital · 10 mg/kg PO q12h · PO · q12h
Initial monotherapy · 3-5 mg/kg PO q12h · PO · q12h
Add-on agent · 10 mg/kg PO q12h · PO · q12h
Epilepsy · 5-10 mg/kg PO q12h · PO · q12h · Gradual adaptation in dosing is recommended. Reduce phenobarbital doses by 25% at the time of starting zonisamide.
Epilepsy (monotherapy or adjunctive) · 5-10 mg/kg · PO · q12h · Long-term · Start at 5 mg/kg q12h. If the dog is concurrently receiving phenobarbital, start at 10 mg/kg q12h due to induced metabolism.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

PORectal

금기

Hypersensitivity to zonisamide
Hypersensitivity to sulfonamide drugs
Pregnancy (known teratogen in dogs)
Hypersensitivity to sulfonamides
Severe hepatic impairment

이상반응

Sedation (usually transient)
Ataxia
Inappetence / Anorexia
Vomiting
Diarrhea
Somnolence
Keratoconjunctivitis sicca (KCS) - theoretical risk due to sulfonamide structure
Polyarthropathy or blood dyscrasias - theoretical risk due to sulfonamide structure
Sedation
Anorexia
Keratoconjunctivitis sicca (KCS)
Hepatotoxicity (rare)
Metabolic acidosis

약물 상호작용

Phenobarbital · Increases the clearance of zonisamide. Repeated phenobarbital dosing decreases the bioavailability, peak concentrations, half-life, and AUC of zonisamide. This effect can persist up to 10 weeks after phenobarbital discontinuation. Higher zonisamide doses are typically required. · moderate
Ketoconazole · May inhibit the hepatic metabolism of zonisamide, potentially increasing serum concentrations. · minor

모니터링

Clinical efficacy (seizure frequency and severity)
Serum zonisamide concentrations (suggested therapeutic range in dogs: 10-40 mcg/mL)
Adverse effects (sedation, ataxia, GI upset)
Schirmer tear test (monitor for KCS due to sulfonamide structure)
Serum zonisamide concentrations (therapeutic target typically 10-40 µg/mL)
Schirmer Tear Test (STT) periodically
Liver enzymes and bilirubin
Complete Blood Count (CBC)

과용량

The LD50 of zonisamide in dogs is reportedly 1 gram/kg. In human overdoses, reported effects include **coma, bradycardia, hypotension, and respiratory depression**. **Treatment**: * GI evacuation if ingestion was recent. * Supportive and symptomatic therapy. * Because of the drug's long half-life, supportive care may be required for several days.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.