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ACETAMIDE  ACETAMIN  ACETARIV  AVVA  DIAMOX  IOPAR-SR  SYNOMAX  ZOLAMIDE 
 
Mechanism of Action
Acetazolamide specifically inhibits the enzyme carbonic anhydrase which catalyses the reversible reaction involving the hydration of CO2 and dehydration of carbonic acid. It increases the excretion of HCO3 ions and as well as Na and K leading to alkaline diuresis. Carbonic anhydrase is also inhibited in the CNS to retard abnormal and excessive discharge from neurons.
Onset:  60-90 min (oral).
Duration:  8-12 hrs (oral).



Indication & Dosage
 
 
Oral
ADJUNCT IN OPEN ANGLE GLAUCOMA
Adult: 250-1000 mg daily in divided doses.
 
Oral
PREOPERATIVE MANAGEMENT OF ANGLE-CLOSURE GLAUCOMA
Child: 1 mth-12 yr: 10-20 mg/kg daily. Max: 750 mg daily, in 2-4 divided doses
 
Oral
PREOPERATIVE MANAGEMENT OF ANGLE-CLOSURE GLAUCOMA
Adult: 250-1000 mg daily in divided doses.
 
Oral
INDUCTION OF DIURESIS
Adult: 250-375 mg daily or on alternate days.
 
Oral
ADJUNCT IN OPEN ANGLE GLAUCOMA
Child: 1 mth-12 yr: 10-20 mg/kg daily. Max: 750 mg daily, in 2-4 divided doses
 
Oral
EPILEPSIES (PETIT/MAL, GRAND MAL, MIXED SEIZURES, MYOCLONIC JERKS, AS ADJUNCT)
Adult: Either alone or with other antiepileptics: 250-1000 mg.
 
Oral
EPILEPSIES (PETIT/MAL, GRAND MAL, MIXED SEIZURES, MYOCLONIC JERKS, AS ADJUNCT)
Child: Neonates and up to 12 yr: Initially, 2.5 mg/kg bid-tid; maintenance: 5-7 mg/kg bid-tid. Max: 750 mg daily.
 
Oral
PROPHYLAXIS OF HIGH-ALTITUDE DISORDERS
Adult: 500-1000 mg daily. Prompt descent is still advised if severe symptoms such as cerebral or pulmonary oedema occur.
 
Intravenous
CHRONIC OPEN-ANGLE GLAUCOMA
Adult: As an adjunct, 250 mg-1 g per 24 hr, usually in divided doses. Adjust dose according to symptomatology and ocular tension
 
Intravenous
ACUTE CLOSED ANGLE GLAUCOMA
Adult: 250 mg every 4 hr. Some patients have resopnded to 250 mg bid.
 
Intravenous
EPILEPSY
Adult: 8-30 mg/kg daily in divided doses. Optimum dose: 375-1000 mg daily. When used in combination with other anticonvulsants, initiate at 250 mg once daily in addition to existing medications and adjust accordingly.
 
Intravenous
CHF
Adult: Initiate at 250-375 mg once daily in the morning (5 mg/kg) on alternate days.
 
Intravenous
DRUG-INDUCED OEDEMA
Adult: 250-375 mg once daily for 1-2 days, alternating with a day of rest
  
AdministrationShould be taken with food.
  
PrecautionsPotassium supplements may be required. Impaired hepatic or renal function; diabetes. Monitor plasma electrolytes and blood count regularly. Caution when driving or operating machinery. Elderly.
  
Potentially Life-threatening 
Adverse Drug Reactions
Drowsiness, paraesthesia, ataxia, dizziness, thirst, anorexia, headache; confusion, malaise, depression; GI distress, metabolic acidosis, polyuria, hyperuricaemia, renal calculi, nephrotoxicity, hepatic dysfunction.
  
Adverse Drug Reactions Rarely, skin reactions or blood dyscrasias.
  
InteractionsAids penetration of weakly acidic substances like sulphonamides across blood and CSF barrier. May inhibit renal excretion of basic drugs (eg, quinidine, ephedrine, amphetamines) and promotes excretion of acidic drugs. May increase salicylate toxicity (acidosis). Hypokalaemia with corticosteroids and potassium-wasting diuretics. May increase excretion of lithium and primidone. May cause osteomalacia with anticonvulsants.
  
   
 

 

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