DRUG CLASS AND MECHANISM:
- Acetazolamide is a strong carbonic anhydrase inhibitor. Carbonic anhydrase is an enzyme found within the red blood cells and helps to regulate the acidity and fluid balance in various organs throughout the body. Carbonic anhydrase catalyzes a reversible reaction that converts carbon dioxide and water into carbonic acid, which can then breakdown into protons and bicarbonate ions.
- In the kidneys and the eyes, carbonic anhydrase promotes the reaction that produces bicarbonate ions and acid to regulate the amount of fluid within these organs. When the delicate balance of this reaction is disturbed, medical problems such as glaucoma and excess fluid retention (edema) may occur. Beneficial effects observed in the treatment of glaucoma include decreases in the secretion of aqueous humor in the eye and intraocular pressure.
- When used as a diuretic (water-pill) in patients who have abnormal fluid retention (for example, heart failure), acetazolamide works in the kidney to promote a reversible reaction that results in the loss of bicarbonate, which carries with it sodium, water, and potassium. In-addition to causing diuresis (water loss), the urine becomes more alkaline or basic (pH increases). Alkalization of the urine causes an increase in the reabsorption of ammonia by the renal tubules.
- Acetazolamide is also used to treat and prevent symptoms of acute mountain sickness (AMS) such as headache, nausea, shortness of breath, dizziness, drowsiness, and fatigue. Compared to placebo, 250 mg acetazolamide every 8-12 hours or 500 mg controlled-release capsule once daily was effective in preventing symptoms of acute mountain sickness before and during rapid ascent to altitude. Compared to placebo, acetazolamide treated patients experienced fewer and/or less severe symptoms, had better lung function, and experienced less difficulty in sleeping.
- Acetazolamide is also used with other medications to treat certain forms of seizures.
REFERENCE: FDA Prescribing Information.
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