Acetazolamide: Difference between revisions
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===[[Glaucoma]]=== | ===[[Glaucoma]]=== | ||
*Closed-angle Glaucoma: | *Closed-angle Glaucoma: | ||
**500mg PO/IV, followed by 125- | **500mg PO/IV, followed by 125-250mg PO q4h | ||
**500mg PO q12h (sustained release) | **500mg PO q12h (sustained release) | ||
*Open-angle Glucoma: | *Open-angle Glucoma: | ||
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===[[Epilepsy]]=== | ===[[Epilepsy]]=== | ||
*8- | *8-30mg/kg/day PO qd | ||
*Do not exceed 30mg/kg/day or 1g/day | *Do not exceed 30mg/kg/day or 1g/day | ||
| Line 31: | Line 31: | ||
===Epilepsy=== | ===Epilepsy=== | ||
*<12 years: safety and efficacy not established | *<12 years: safety and efficacy not established | ||
*>12 years: 8- | *>12 years: 8-30mg/kg/day PO qd | ||
===[[Acute altitude sickness]]=== | ===[[Acute altitude sickness]]=== | ||
*<12 years: safety and efficacy not established | *<12 years: safety and efficacy not established | ||
*>12 years: 500- | *>12 years: 500-1000mg PO qd | ||
==Special Populations== | ==Special Populations== | ||
Revision as of 09:44, 19 July 2016
General
- Type: Carbonic anhydrase inhibitor
- Dosage Forms: PO/IV
- Common Trade Names: Diamox
Adult Dosing
Glaucoma
- Closed-angle Glaucoma:
- 500mg PO/IV, followed by 125-250mg PO q4h
- 500mg PO q12h (sustained release)
- Open-angle Glucoma:
- 250mg-1g PO/IV qd
- 500mg PO q12h (sustained release)
Acute altitude sickness
- 500-1000mg extended release PO qd
- Continue treatment for 48 hours or longer if necessary
CHF-associated Edema
- 250-375mg PO qAM
- 5mg/kg
Drug-induced Edema
- 250-375mg PO qAM
Epilepsy
- 8-30mg/kg/day PO qd
- Do not exceed 30mg/kg/day or 1g/day
Pediatric Dosing
Epilepsy
- <12 years: safety and efficacy not established
- >12 years: 8-30mg/kg/day PO qd
Acute altitude sickness
- <12 years: safety and efficacy not established
- >12 years: 500-1000mg PO qd
Special Populations
- Pregnancy Rating: C
- Lactation risk: Safe
- Renal Dosing
- Adult: CrCl 10-50: give q12h; CrCl<10: avoid use; HD/PD: not defined
- Pediatric: CrCl 10-50: give q12h; CrCl<10: avoid use, HD/PD: not defined
- Hepatic Dosing
- Adult: contraindicated in significant impairment/cirrhosis
- Pediatric: contraindicated in significant impairment/cirrhosis
Contraindications
- Allergy to class/drug
- hypokalemia
- hyponatremia
- acidosis, hyperchloremic
- acidosis, metabolic
- adrenal insufficiency
- cirrhosis
- hepatic disease, severe
- renal disease, severe
- glaucoma, angle-closure (long-term use)
- caution if hypersensitivity to sulfonamides
- caution if ASA treatment, high-dose
- caution if hepatic impairment
- caution if pulmonary impairment
- caution if diabetes mellitus
- caution if gout
- caution if elderly patients
Adverse Reactions
Serious
- metabolic acidosis
- electrolyte imbalance
- anaphylaxis
- erythema multiforme
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- hepatic necrosis
- hepatic impairment
- agranulocytosis
- anemia, hemolytic
- myelosuppression
- leukopenia
- pancytopenia
- blood dyscrasias
- thrombocytopenic purpura
- seizures
- paralysis, flaccid
- crystalluria
- nephrolithiasis
Common
- fatigue
- malaise
- taste change
- anorexia
- nausea/vomiting
- parethesia
- diarrhea
- polyuria
- electrolyte disorders
- tinnitus
- hearing changes
- myopia
- drowsiness
- confusion
- uticaria
- rash
- photosensitivity
- glucosuria
- hematuria
- melena
Pharmacology
- Half-life: 10-15h
- Metabolism: CYP450
- Excretion: urine (100% unchanged)
- Mechanism of Action: inhibits carbonic anhydrase