Mindanao State University – Iligan Institute of Technology Student: _________________________ Section:___________

PHARMACOLOGY

DRUG STUDY

Brand Name: Diamox___________________________________ Generic Name: Acetazolamide ________________________ Drug Classification: Carbonic Anhydrase Inhibitor

Dosage, Route & Frequency Drug-Drug &

Side Effects Adverse Reactions
Drug Action Drug-Food Indications Contraindications
Recommended Prescribed (By System) (By System)
Interactions
Oral dosage (extended-release Inhibition of carbonic Drug-Drug: Lowering of intraocular Hypersensitivity or Dizziness, CNS: depression,
capsules) anhydrase in the eye results Excretion of pressure in the cross-sensitivity with lightheadedness, or fatigue, weakness,
Adults: 500 mg PO twice daily. The in decreased secretion of barbiturates, aspirin, treatment of glaucoma. sulfonamides may increased urination may drowsiness.
maximum dosage is 1 g/day. aqueous and lithium is Management of acute occur; Hepatic disease occur, especially during EENT: transient
Children and Adolescents 12 humor. Inhibition of renal increased and may altitude sickness. or insufficiency; the first few days as nearsightedness.
years and older: 500 mg PO twice carbonic anhydrase, resulting lead to decreased Unlabeled Use: Concurrent use with your body adjusts to the GI: anorexia, metallic
daily. Doses greater than 1,000 in self-limiting urinary effectiveness. Diuretic. Adjunct to the ophthalmic carbonic medication. Blurred taste, nausea, vomiting,
mg/day are not usually associated excretion of sodium, Excretion of treatment of refractory anhydrase inhibitors vision, dry mouth, melena. GU:
with an increased effect. potassium, bicarbonate, and amphetamine, seizures. Reduce (brinzolamide, drowsiness, loss of crystalluria, renal
Glaucoma water. CNS inhibition of quinidine, cerebrospinal fluid dorzolamide) is not appetite, nausea, calculi.
Adults: 250 mg PO every 4 hours. carbonic anhydrase and procainamide, and production in recommended; OB: vomiting, diarrhea, or Derm: STEVENS-
Alternately, treatment of some acute resultant diuresis may possibly tricyclic hydrocephalus. Avoid during first changes in taste may JOHNSON
types of glaucoma has been initiated decrease abnormal neuronal antidepressants is Prevention of renal trimester of pregnancy. also occur. SYNDROME, rashes.
with a dose of 500 mg, followed by firing. Alkaline diuresis decreased and may calculi composed of uric Endo: hyperglycemia
125 to 250 mg PO every 4 hours. prevents precipitation of uric lead to toxicity. May acid or cystine. F and E:
Intravenous dosage acid or cystine in the urinary increase hyperchloremic
Adults: 500 mg IV for acute lowering tract. cyclosporine levels. acidosis, hypokalemia,
of IOP or in patients unable to take Therapeutic Effects: growth retardation (in
the oral dosage. If needed, may Lowering of intraocular children receiving
repeat the dose in 2 to 4 hours. pressure. Control of some chronic therapy).
Acute Altitude Sickness types of seizures. Prevention Hemat: APLASTIC
Immediate release: 500-1000 and treatment of acute ANEMIA, HEMOLYTIC
mg/day PO divided q8-12hr altitude sickness. Diuresis ANEMIA,
Extended release: 500-1000 mg PO and subsequent mobilization LEUKOPENIA. Metab:
q12-24hr of excess fluid. Prevention of weight loss,
Congestive Heart Failure uric acid or cystine renal hyperuricemia. Neuro:
CHF-associated edema calculi. paresthesias.
250-375 mg (5 mg/kg) PO qAM Absorption: Dose Misc:allergic reactions
Seizure dependent; erratic with doses including
8-30 mg/kg/day PO qDay or divided 10 m g/kg/day. ANAPHYLAXIS.
q12hr Distribution: Crosses the
 Drug-induced Edema placenta and blood-brain
250-375 mg PO/IV qDay barrier; enters breast milk.
Epilepsy Protein Binding: 95%.
Tablet: 8-30 mg/kg/day PO qDay, Metabolism and Excretion:
OR divided q6-12 hr; not to exceed Excreted mostly unchanged
30 mg/kg/day or 1 g/day in urine.
Half-life: 2.4– 5.8 hr.

Responsibilities in the Nursing Process (ADPIE)
Assessment
● Observe for signs of hypokalemia (muscle weakness, malaise, fatigue, ECG changes, vomiting).
● Assess for allergy to sulfonamides.
● Intraocular Pressure: Assess for eye discomfort or decrease in visual acuity.
● Seizures: Monitor neurologic status in patients receiving acetazolamide for seizures. Initiate seizure
precautions.
● Altitude Sickness: Monitor for decrease in severity of symptoms (headache, nausea, vomiting, fatigue,
dizziness, drowsiness, shortness of breath). Notify health care professional immediately if neurologic
symptoms worsen or if patient becomes more dyspneic and rales or crackles develop.
● Edema: Monitor intake and output ratios and daily weight during therapy
Potential Nursing Diagnoses
Disturbed sensory perception (visual) (Indications)
Implementation
● Do not confuse acetazolamide with acetohexamide. Do not confuse Diamox with Diabinese.
● Encourage fluids to 2000– 3000 mL/day, unless contraindicated, to prevent crystalluria and stone
formation.
● A potassium supplement without chloride should be administered concurrently with acetazolamide.
● PO: Give with food to minimize GI irritation. Tablets may be crushed and mixed with fruit-flavored syrup to
minimize bitter taste for patients with difficulty swallowing. Extended-release capsules may be opened and
sprinkled on soft food, but do not crush, chew, or swallow contents dry. Extended-release capsules are only
indicated for glaucoma and altitude sickness; do not use for epilepsy or diuresis.
● IM: Extremely painful; avoid if possible.
Responsibilities in the Nursing Process (ADPIE)
Patient/Family Teaching
● Instruct patient to take as directed. Take missed doses as soon as possible unless almost time for next
dose. Do not double doses. Patients on anticonvulsant therapy may need to gradually withdraw
medication.
● Advise patient to report numbness or tingling of extremities, weakness, rash, sore throat, unusual
bleeding or bruising, fever, or signs/symptoms of a sulfonamide adverse reaction (Stevens-Johnson
syndrome [flu-like symptoms, spreading red rash, or skin/mucous membrane blistering], toxic epidermal
necrolysis [widespread peeling/blistering of skin]) to health care professional. If hematopoietic reactions,
fever, rash, hepatic, or renal problems occur, acetazolamide should be discontinued.
● May occasionally cause drowsiness. Caution patient to avoid driving and other activities that require
alertness until response to the drug is known.
● Caution patient to use sunscreen and wear protective clothing to prevent photosensitivity reactions.
● Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal
products being taken and to consult with health care professional before taking other medications.
● Intraocular Pressure: Advise patient of the need for periodic ophthalmologic exams; loss of vision may
be gradual and painless.
Evaluation/Desired Outcomes
● Decrease in intraocular pressure when used for glaucoma. If therapy is not effective or patient is unable
to tolerate one carbonic anhydrase inhibitor, using another may be effective and more tolerable.
● Decrease in the frequency of seizures.
● Reduction of edema.
● Prevention of altitude sickness.
● Prevention of uric acid or cystine stones in the urinary tract

REFERENCES:

https://reference.medscape.com/drug/diamox-acetazolamide-342809
https://fadavispt.mhmedical.com/content.aspx?bookid=1873&sectionid=139000247
https://www.webmd.com/drugs/2/drug-6753/diamox-oral/details
https://davisplus.fadavis.com/3976/meddeck/pdf/acetazolamide.pdf