Home Drug Guide Acetazolamide Sodium

Drug Guide

Generic Name

Acetazolamide Sodium

Brand Names Diamox

Classification

Therapeutic: Anticonvulsant, Diuretic, Carbonic Anhydrase Inhibitor

Pharmacological: Carbonic Anhydrase Inhibitor

FDA Approved Indications

  • Glaucoma (ocular HTN)
  • Edema associated with congestive heart failure or drug therapy
  • Altitude sickness
  • Epilepsy (adjunct)
  • Metabolic alkalosis

Mechanism of Action

Inhibits carbonic anhydrase enzyme, leading to decreased hydrogen ion secretion at nephrons, resulting in diuresis and reduction in aqueous humor formation.

Dosage and Administration

Adult: Dose varies by indication; for glaucoma, usual starting dose is 250 mg twice daily, adjusted as needed.

Pediatric: Dose varies based on age and indication; consult specific protocols.

Geriatric: Start at lower doses due to increased risk of side effects.

Renal Impairment: Adjust dose; clearance is reduced, risking toxicity.

Hepatic Impairment: Use with caution; no specific adjustment specified.

Pharmacokinetics

Absorption: Well absorbed orally

Distribution: Widely distributed; crosses blood-brain barrier

Metabolism: Minimal hepatic metabolism

Excretion: Primarily renal excretion

Half Life: 10-15 hours in healthy adults

Contraindications

  • Hypersensitivity to sulfonamides or acetazolamide
  • Severe hepatic or respiratory acidosis
  • Electrolyte imbalance (e.g., hyponatremia, hypokalemia)

Precautions

  • Monitor electrolytes, renal function, and acid-base status regularly.
  • Use with caution in patients with kidney or liver impairment, pregnancy, and lactation.

Adverse Reactions - Common

  • Paresthesias (Common)
  • Altered taste (Common)
  • Polyuria (Common)
  • Metabolic acidosis (Less common)

Adverse Reactions - Serious

  • Agranulocytosis (Rare)
  • Neutropenia (Rare)
  • Electrolyte disturbances (hypokalemia, hyponatremia) (Less common)
  • Allergic reactions including rash and Stevens-Johnson syndrome (Rare)

Drug-Drug Interactions

  • Lithium (increased serum levels)
  • Corticosteroids (electrolyte imbalances)
  • Other diuretics

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor electrolyte levels, renal function, and for signs of metabolic acidosis.

Diagnoses:

  • Electrolyte imbalance
  • Risk for dehydration
  • Risk for acid-base imbalance

Implementation: Administer with food or after meals if GI upset occurs; monitor laboratory values regularly.

Evaluation: Assess for therapeutic effects and adverse reactions, including intraocular pressure reduction and electrolyte stability.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report signs of electrolyte imbalance (muscle weakness, irregular heartbeat).
  • Use sunscreen to prevent photosensitivity.
  • Maintain adequate hydration.

Special Considerations

Black Box Warnings:

  • None explicitly, but caution in use in patients with sulfa allergies.

Genetic Factors: Sulfa allergy history is relevant.

Lab Test Interference: May cause false increase in serum bicarbonate and glucose tests.

Overdose Management

Signs/Symptoms: Severe metabolic acidosis, electrolyte disturbances, sedation, coma.

Treatment: Supportive care, correction of electrolyte imbalances, possibly hemodialysis in severe cases.

Storage and Handling

Storage: Store at room temperature, protected from moisture and light.

Stability: Stable for 24 months when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.