Aцetazolamid

When ATH:
S01EC01

Characteristic.

The white crystalline powder;. Very slightly soluble in water, alcohol, acetone, practically insoluble in carbon tetrachloride, xloroforme, ether, readily soluble in alkaline solutions.

Pharmacological action.
Diuretic, protivoglaukomnoe, antiepileptic.

Application.

Glaucoma (chronic open, secondary, острая закрытоугольная — кратковременное предоперационное лечение с целью снижения внутриглазного давления); epilepsy (large and small seizures seizures in children, mixed forms) in combination with an anticonvulsant; swelling (amid cardiopulmonary diseases or drug induced); mountain sickness (to reduce the time of acclimatization).

Contraindications.

Hypersensitivity (incl. other sulfonamides), giponatriemiya, kaliopenia, Adrenal insufficiency, kidney or liver failure, cirrhosis of the liver (the risk of encephalopathy), urolithiasis disease (when hypercalciuria), hyperchloraemic acidosis, hronicheskaya dekompensirovannaya zakrыtougolynaya glaucoma (for long-term therapy), diabetes, uremia, lactation.

Restrictions apply.

Pulmonary embolism, emphysema (may increase acidosis), pregnancy.

Pregnancy and breast-feeding.

Not recommended during pregnancy (especially in the I trimester), in each case should be evaluated the effect of therapy and the potential risk to the fetus.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: drowsiness, hearing loss / tinnitus, taste disturbance, passing myopia, disorientation, paraesthesia, convulsions.

From the digestive tract: loss of appetite, nausea, vomiting, diarrhea, ground, hepatic failure.

Metabolism: metabolic acidosis and electrolyte imbalance (prolonged use).

Other: hives, sensitivity to light, polyuria, hematuria, glycosuria.

Cooperation.

The diuretic effect is enhanced by theophylline, weakened by acid-forming diuretics.

Dosing and Administration.

Inside, glaucoma Dose picked individually depending on the performance of intraocular pressure, средние дозы — по 125–250 мг 1–3 раза в сутки через день в течение 5 days, затем — перерыв 2 day. In epilepsy взрослым — 250–500 мг 1 once a day for 3 days, на 4-й — перерыв; детям — в зависимости от массы тела, 1-2 reception; acetazolamide in combination with anticonvulsants, the initial dose 250 mg 1 once a day (If necessary to increase); children should not use doses higher, than 750 mg / day. Swelling — 250–375 мг в сутки утром; the maximum diuretic effect is achieved by taking a day or 2 consecutive days with a one-day break. Mountain sickness - By 250 mg 2-3 times a day, прием следует начинать за 24–48 ч перед восхождением и продолжать в течение 48 no (If necessary, longer).

Precautions.

This hypersensitivity to sulfonamides may develop severe side effects: anaphylaxis, fever, rash (incl. erythema multiforme exudative, Syndrome Stevens - Johnson, toxic epidermal necrolysis), kristallurija, kidney stones, bone marrow depression, trombotsitopenicheskaya purpura, gemoliticheskaya anemia, leukopenia, pancytopenia and agranulocytosis.

In case of skin changes or changes in the pattern of blood drug should be lifted immediately.

Care should be taken while the application of acetazolamide with acetylsalicylic acid (high dose) Because of the possibility of anorexia, tachypnea, lethargic state, coma or even death.

During prolonged use, requires monitoring the level of electrolytes in serum, as well as control of peripheral blood picture. Aцetazolamid, used in large doses, than recommended, It does not increase urine output, and often reduces its, at the same time increases drowsiness and / or paresthesia. Under certain circumstances, However, it is used in very high doses, together with other diuretics in order to ensure a reliable urine output with a fully refractory heart failure.

Should not be used during the drivers of vehicles and people, skills relate to the high concentration of attention.

Cooperation