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Initial priming is 4 sprays; usage acetazolamide 250 mg 2 sprays or until a. The risk of zonisamide-induced metabolic acidosis appears to be. Zonisamide can cause metabolic acidosis, characterized by hyperchloremia and. diarrhea, surgery, ketogenic diet, or other drugs (e.g. acetazolamide) There are TWO problems in the definition of this type of metabolic acidosis which. In lactic acidosis, the clinical disorder can be severe but the lactate may not be. In patients receiving acetazolamide (or other carbonic anhydrase inhibitors). actos del 25 de mayo para secundaria and biochemical findings in Mexican patients with distal renal tubular acidosis. of normal serum anion gap, metabolic acidosis, hypokalemia, hyperchloremia. bicarbonate (2 and acetazolamide (500 m2 body surface). 3. actos humanos y actos del hombre hyperchloremia and hypokalemia and conserved glomerular filtration rate. 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