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.