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Diamox

Acetazolamide, sold under the trade name Diamox®, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension and altitude sickness. For glaucoma sufferers, the drug decreases fluid formation around the eye resulting in lower internal pressure on the eye. Acetazolamide can only be obtained by prescription and is available as a generic drug. more...

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Uses

General

Acetazolamide is used in glaucoma and epilepsy. In epilepsy, its main use is in absence seizures, with some benefit in other seizure syndromes. It is also used to decrease generation of cerebrospinal fluid in benign intracranial hypertension.

Altitude sickness

Acetazolamide has been shown to relieve mild cases of altitude sickness in some people. The drug forces the kidneys to excrete bicarbonate, the base form of carbon dioxide thus counteracting the effects of hyperventilation that occurs at altitude. Some take acetazolamide prophylactically, anywhere between 125 milligrams (mg) to 500 mg per day. Others only take it when symptoms begin to appear so they can tell whether the drug really has any benefits for them. Acetazolamide can also be taken to treat sleep apnea that may develop at higher elevations as it stimulates the respiratory system to breathe more regularly. Note that acetazolamide is not an immediate quick fix – it speeds up acclimatization which in turn helps to relieve symptoms. This may take up to a day or two without any further rapid ascent.

Side-effects

Common side effects of using this drug include numbness and tingling in the fingers and toes, and taste alterations (especially for carbonated drinks); both are usually due to mild hypokalemia (low potassium levels). Some may also experience blurred vision but this usually disappears shortly after stopping the medication. Everyone will experience more frequent urination as a result of using acetazolamide. One should drink more fluids than usual to prevent dehydration and headaches.

Contraindications

Acetazolamide should not be taken by individuals if:

  • They are allergic to sulfa medications
  • They are allergic to any carbonic anhydrase inhibitor
  • They have liver or kidney disease
  • They have adrenal gland failure (i.e. Addison's disease)
  • They have diabetes

Myths

  • Acetazolamide covers up symptoms. Acetazolamide speeds up acclimatization which in turn helps to alleviate symptoms. However, if you still feel sick, you need to stop ascending immediately.
  • Acetazolamide prevents acute mountain sickness from getting worse. If your symptoms are not improving, continued ascent can lead to HAPE or HACE.
  • Stopping the drug causes symptoms to worsen. Your body will just return to its own acclimatization rate. If you are already acclimatized, the drug will not change that fact.

Read more at Wikipedia.org


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Role Of Diamox In Compensated Respiratory Acidosis: Can It Improve Ventilation? - Abstract
From CHEST, 10/1/00 by George Robert

George Robert, MD(*) and K Padmanabhan, MD. Coney Island Hospital, Brooklyn, NY.

PURPOSE: To determine if use of Diamox in patients(pts) with Compensated Respiratory Acidosis (CRA) whose alveolar hypoventilation was out of proportion to the severity of their causative disorder, would improve ventilation by a reduction of serum bicarbonate(HCO3) resulting in a reduction of CSF HCO3 thereby causing CSF acidosis leading to improved respiratory center drive.

METHODS: 4 pts(3 COPD & 1 Obesity - Hypoventilation) with CRA and stable respiratory status were identified on the basis of having alveolar hypoventilation out of proportion to their baseline lung function. Pts selected had serum HCO3 over 40meq/L and serum pH between 7.30 and 7.34. All pts had spirometry and ABG before and after diamox (250 mg BID), for 4 doses. Changes in PCO2, HCO3, and pH were recorded. Out of the 4 pts, one had 2 events recorded at different times.

RESULTS: PCO2 and HCO3 decreased by a mean of 23mm of Hg and 12 meq/L respectively, without significant changes in pH or FEV1.

CONCLUSION: In some pts, with compensated respiratory acidosis diamox can safely be used to increase alveolar ventilation by decreasing total body HCO3.

CLINICAL IMPLICATIONS: The presence of compensated respiratory acidosis does not preclude a trial of diamox in an attempt to improve ventilation in pts where alveolar hypoventilation is out of proportion to the severity of the underlying disease.

COPYRIGHT 2000 American College of Chest Physicians
COPYRIGHT 2001 Gale Group

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