Acetazolamide Drug Study
Generic Name:
Acetazolamide
Brand Names:
Diamox, Diamox Sequels
Drug Classification:
Carbonic anhydrase inhibitor
Diuretic
Mechanism of Action:
Acetazolamide inhibits the enzyme carbonic anhydrase, which is involved in the reversible hydration of
carbon dioxide and dehydration of carbonic acid. By inhibiting this enzyme, acetazolamide decreases the
reabsorption of bicarbonate in the kidneys, leading to increased excretion of bicarbonate, sodium,
potassium, and water. This results in alkaline urine and decreased formation of aqueous humor in the
eye, thereby reducing intraocular pressure.
Indications:
Acetazolamide is used to treat:
Glaucoma (chronic simple, acute angle-closure, and secondary)
Edema (associated with congestive heart failure, drug-induced, or other causes)
Epilepsy (as an adjunctive treatment)
Acute mountain sickness (prevention and treatment)
Dosage and Administration:
Adults:
Glaucoma: 250-1000 mg per day in divided doses.
Edema: 250-375 mg once daily in the morning. For resistant edema, an intermittent dosage
schedule (every other day or 2 days on, 2 days off) may be used.
Epilepsy: 8-30 mg/kg/day in divided doses.
Acute Mountain Sickness: 500-1000 mg per day in divided doses. Treatment should start 24-48
hours before ascent and continue for 48 hours while at high altitude or longer as necessary.
Pediatrics:
Dosage for children is usually based on body weight and specific indication. Consultation with a
healthcare provider is necessary.
Pharmacokinetics:
Absorption: Rapidly absorbed from the gastrointestinal tract.
Distribution: Widely distributed throughout the body, including the central nervous system.
Metabolism: Not significantly metabolized.
Excretion: Excreted unchanged primarily via the urine. The half-life is approximately 10-15 hours.
Side Effects:
Common side effects may include:
Paresthesia (tingling or pricking sensation)
Increased urination
Loss of appetite
Taste alteration (metallic taste)
Drowsiness
Diarrhea
Serious side effects, though rare, may include:
Metabolic acidosis
Electrolyte imbalance (hypokalemia, hyponatremia)
Blood dyscrasias (aplastic anemia, thrombocytopenia)
Severe allergic reactions (Stevens-Johnson syndrome, anaphylaxis)
Kidney stones
Contraindications:
Known hypersensitivity to acetazolamide or sulfonamides
Severe renal or hepatic impairment
Adrenocortical insufficiency
Hyperchloremic acidosis
Long-term use in chronic non-congestive angle-closure glaucoma
Precautions:
Use with caution in patients with a history of kidney stones, electrolyte imbalances, or
respiratory acidosis.
Monitor for signs of metabolic acidosis, especially in patients with diabetes or renal impairment.
Caution is advised in patients with respiratory disorders, as acetazolamide may exacerbate
respiratory acidosis.
Interactions:
Salicylates (e.g., aspirin): Increased risk of toxicity due to competition for renal excretion.
Other diuretics: Increased risk of electrolyte imbalance.
Antiepileptic drugs (e.g., phenytoin): May alter the effectiveness of acetazolamide.
Lithium: May decrease serum lithium levels and reduce its effectiveness.
Monitoring:
Monitor blood electrolytes, particularly sodium, potassium, and bicarbonate levels.
Assess for signs of metabolic acidosis, such as hyperventilation, fatigue, and altered mental
status.
Regular monitoring of blood cell counts during prolonged therapy.
Monitor renal and liver function periodically during long-term use.
Patient Education:
Take acetazolamide exactly as prescribed, and do not exceed the recommended dose.
Drink plenty of fluids to reduce the risk of kidney stones.
Avoid prolonged exposure to sunlight, as acetazolamide can increase the risk of sunburn.
Report any signs of severe side effects, such as unusual tiredness, muscle weakness, or signs of
an allergic reaction, to your healthcare provider promptly.
Inform your healthcare provider of any other medications you are taking, including over-the-
counter drugs and supplements.
Do not stop taking acetazolamide abruptly without consulting your healthcare provider,
especially if you are taking it for epilepsy.
Conclusion:
Acetazolamide is a versatile medication used to manage conditions such as glaucoma, edema, epilepsy,
and acute mountain sickness. It is generally well-tolerated, but patients should be aware of potential side
effects and the need for regular monitoring of blood electrolytes and organ function. Proper patient
education and adherence to prescribed dosages are essential to ensure safe and effective use of this
medication.
