Acetazolamide (Na)

Acetazolamide (Na) is a prototype carbonic anhydrase inhibitor. Acetazolamide (Na) is a non-bacteriostatic sulfonamide possessing a chemical structure and pharmacological activity distinctly diffrent from the bacteriostatic sulfonamides. The sulfonamide group is essential for the activity of acetazolamide. Carbonic anhydrase inhibitors were the forerunners of the modern diuretics. They are unsubstituted sulfonamide derivative and were developed when it was noted that bacteriostatic sulfonamide caused a alkaline diuresis. With the development of newer agent, the carbonic anhydrase inhibitors are now rarely used. It decreases activity of the nerves in the brain which make it useful as an anticonvulsant drug in the treatment of certain seizure disorders such as epilepsy.

Brands
EVAMOX AZM DIAMOX SETACAR ACEMOX
Adult Dose
Dose: 250 to 1000 mg
Single Dose: 620 (625)
Frequency: 12 hourly
Route: PO
Instructions:
Neonatal
Dose: 2 to 6 mg/kg
Single Dose: 4 (4)
Frequency: 8 hourly
Route: Intravenous
Instructions:
Paedriatic
Dose: 8 to 30 mg/kg
Single Dose: 19 (19)
Frequency: As recommended.
Route: oral
Instructions: Maximum 750mg/day in 2-3 doses
Characteristics
Acetazolamide (Na) also known as Acetazolam. . It is of Synthetic origin and belongs to Sulphonamide. It belongs to Diuretics pharmacological group.The Molecular Weight of Acetazolamide (Na) is 222.25. 3.85% solution of the drug is isotonic and Its pKa is 7.2, 9.0.
Contraindications
'Acetazolamide (Na) is contraindicated in conditions like Renal hyperchloremic acidosis,Addison''s disease,Liver diseases,Close-angle glaucoma,Hepatic encephalopathy,Kidney disease.'
Effects
The severe or irreversible adverse effects of Acetazolamide (Na), which give rise to further complications include Growth retardation.Acetazolamide (Na) produces potentially life-threatening effects which include Blood disorders, Skin toxicity, Urinary stone formation, Aplastic Anemia, Stevens Johnson syndrome, Stevens Johnson syndrome, Potassium loss, Aplastic anemia, Metabolic acidosis. which are responsible for the discontinuation of Acetazolamide (Na) therapy.The signs and symptoms that are produced after the acute overdosage of Acetazolamide (Na) include Disorientation, Drowsiness.The symptomatic adverse reactions produced by Acetazolamide (Na) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Thirst, Headache, Drowsiness, Fatigue, Irritability, Excitement, Ataxia, Hyperpnea, Fever, Rashes, GI upset, Flushing, Paresthesias, Hyperphosphatemia, dizziness, bone marrow depression, bone marrow depression.
Indications
Acetazolamide (Na) is primarily indicated in conditions like Edema, Epilepsy, Fluid retention, Glucoma, Oedema, and can also be given in adjunctive therapy as an alternative drug of choice in Mountain sickness, Periodic paralysis.
Interactions
Acetazolamide (Na) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAmphetamineAcetazolamide reduce urinary excretion and enhance pharmacological effectAspirinAspirin displace acetazolamide from plasma protein binding site and reduce renal clearence results in severe metabolic acidosis and/or salicylate toxicity. Acetazolamide change the pH of plasma due to which amount of unionized salicylates increase which may enter in CNS result in coma and death.MajorConcomitant use should be avoided but if necessary monitor the patient`s mental status and acid base balance very carefully.Diethylcarbamazine (Citrate)Acetazolamide reduce urinary excretion and enhance pharmacological effectEphedrineErythromycinFosphenytoinMethenamineAcetazolamide keep urine alkaline and prevent urinary antiseptic effect of methenamineMethotrexateAcetazolamide potentiate effect of phenytoinPhenytoin (Na)Acetazolamide potentiate effect of phenytoinPrimidoneQuinidineAcetazolamide reduce urinary excretion and enhance pharmacological effectQuinineAcetazolamide reduce urinary excretion and enhance pharmacological effectTriazolamWarfarin (Na)Acetazolamide potentiate effect of phenytoin These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
False -ve values for the estimation of urinary protein, serum non-protein and for serum uric acid
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, patients suffering from Kidney dysfunction, patients suffering from Liver Malfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj (reconstituted soln) Store at room temperature or refrigerator. Use within 1 week if refrigerated and within 24 hrs if kept at room temperature. Tab Store in a well closed container, Below 40°C. Protect from Sunlight and Moisture.
Warnings
Use with caution in patients with severe respiratory acidosis or pulmonary obstruction. Balanced electrolyte intake is essential in all patients whose clinical condition may cause electrolyte imbalance. Sensitvity to Surphoramide
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