DRUG STUDY

ACETAZOLAMIDE
Brand and Other Names:Diamox Sequels
Classes: Anticonvulsants, Other;
Antiglaucoma, Carbonic Anhydrase Inhibitors

Dosage Forms & Strengths

Tablet
 125mg
 250mg
Powder for injection
 500mg
Capsule, extended-release
 500mg

Glaucoma
Closed-angle (acute congestive) glaucoma
 500 mg PO/IV, followed by 125-250 mg PO q4hr
 Sustained-release: 500 mg PO q12hr
Open-angle (chronic simple) glaucoma
 250 mg-1 g PO/IV qDay or divided q6-12hr
 Sustained-release: 500 mg PO q12hr
Secondary glaucoma
 500 mg PO/IV, followed by 125-250 mg PO q4hr
 Sustained-release: 500 mg PO q12hr

Acute Altitude Sickness

Immediate release: 500-1000 mg/day PO divided q8-12hr
Extended release: 500-1000 mg PO q12-24hr
Dosing considerations
 Start 24-48 hours before ascent and continue for 48 hours at high altitude or longer, to
control symptoms if necessary
Congestive Heart Failure
CHF-associated edema
250-375 mg (5 mg/kg) PO qAM
Seizure
8-30 mg/kg/day PO qDay or divided q12hr
Drug-induced Edema
250-375 mg PO/IV qDay
Dosing considerations
 Do not increase dose if edema fails to decrease following an initial response; allow instead
kidney recovery by skipping medication for a day; best results obtained when given on
alternate days or for 2 days followed by a day of rest
Epilepsy
Tablet: 8-30 mg/kg/day PO qDay, OR divided q6-12 hr; not to exceed 30 mg/kg/day or 1 g/day
Extended-release capsule: Not recommended
Dosing Modifications
Renal impairment
 CrCl 10-50 mL/min: Administer no more frequently than q12hr
 CrCl <10 mL/min: Ineffective (avoid use)
 Hemodialysis: 20-50% dialyzable
 Peritoneal dialysis: Dose adjustment not necessary
Adverse Effects
Confusion
Convulsions
Drowsiness
Flaccid paralysis
Malaise
Paresthesias
Photosensitivity
Urticaria
Anorexia
Diarrhea
Metallic taste
Nausea
Vomiting
Hepatic disease
Aplastic anemia
Agranulocytosis
Leukopenia
Thrombocytopenia
Thrombocytopenic purpura
Melena
Acidosis
Electrolyte imbalance
Muscle weakness
Hematuria
Polyuria
Glycosuria
Hearing dysfunction or tinnitus
Sulfonamide type reactions

Warnings

Contraindications
Hypokalemia
Hyponatremia
Hyperchloremic acidosis
Hypersensitivity to acetazolamide or sulfa
Liver disease
Severe renal disease or dysfunction
Long term use in noncongestive angle-closure glaucoma
Cirrhosis
Long-term administration in patients with chronic, noncongestive angle-closure glaucoma
Cautions
Use caution in COPD, emphysema, and concomitant high-dose aspirin
Use caution in diabetes, respiratory acidosis, and hepatic impairment
Adverse drug reactions common to sulfonamide derivatives; Stevens-Johnson syndrome and
toxic epidermal necrolysis (TEN) may occur
May impair alertness and/or physical coordination
FDA-approved product labeling for many medications have included a broad contraindication in
patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested
that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely
to occur
May impair alertness and/or physical coordination
Severe adverse effects including tachypnea, anorexia, coma, lethargy, and death reported with
high-dose aspirin; use caution or avoid administration
Increasing dose does not increase diuresis; may instead increase the incidence of paresthesia
and/or drowsiness
IM administration not recommended due to alkaline pH, which may cause pain.

Mechanism of Action
Carbonic anhydrase inhibitor that decreases rate of aqueous humor formation, in that way
decreasing intraocular pressure
Inhibits H+ ion excretion in renal tubule, increasing sodium, potassium, bicarbonate, and water
excretion and producing alkaline diuresis
Inhibits carbonic anhydrase in CNS, which in turn decreases abnormal and excessive discharge
from the CNS neurons
Absorption
Bioavailability: Rapidly absorbed orally
 In Partial Fulfillment of the
Requirements in NCM 104

MED 3
Neuroscience Ward

Submitted to: Sir Jesse Bantali

Submitted by: Grail Ann Carantes
Date: Feb. 22,2020