Diamox is an FDA-approved medication used to treat certain types of glaucoma, congestive heart failure, certain types of seizures. Diamox also prevents altitude sickness.
Other names for this medication:
Also known as: Acetazolamide.
Diamox contains an active ingredient Acetazolamide, which belongs to class of drugs called carbonic anhydrase inhibitors.
Diamox effectively treats certain types of glaucoma (excessive pressure in the eyes) by reducing the amount of fluid in the eye, and thereby decreases pressure inside the eye.
Acetazolamide acts also as a diuretic ("water pill") and inhibits the protein in the body called carbonic anhydrase. This leads to reducing the build-up of certain fluids in the body, significantly alleviating the symptoms of congestive heart failure.
Acetazolamide is also used to treat certain types of seizures, and to treat or prevent altitude sickness.
Diamox is available in tablets.
The dosage depends on the disease and its prescribed treatmen.
250 mg to 1 gram per 24 hours in 2 or more smaller doses.
In secondary glaucoma and before surgery in acute congestive (closed-angle) glaucoma, the usual dosage is 250 mg every 4 hours or, in some cases, 250 mg twice a day.
The daily dosage is 8 to 30 mg per 2.2 pounds of body weight in 2 or more doses. Typical dosage may range from 375 to 1,000 mg per day.
Congestive Heart Failure treatment:
The usual dosage is 250 mg to 375 mg per day or 5 mg per 2.2 pounds of body weight, taken in the morning.
Diamox can be used by children.
If you want to achieve most effective results do not stop taking Diamox suddenly.
If you overdose Diamox and you don't feel good you should visit your doctor or health care provider immediately.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.
The most common side effects associated with Diamox are:
Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.
Do not take Diamox if you are allergic to Diamox components.
Be careful with Diamox if you're pregnant or you plan to have a baby, or you are a nursing mother.
Do not take Diamox if your sodium or potassium levels are low.
Do not take Diamox if you have kidney or liver disease, including cirrhosis.
Be careful with Diamox if you suffer from or have a history of emphysema or other breathing disorders.
Be careful with Diamox if you take high doses of aspirin.
Be careful with Diamox if you are taking Amitriptyline, Cyclosporine, Lithium, Methenamine, oral diabetes drugs such as Glyburide, Quinidine.
Do not use potassium supplements or salt substitutes.
If you want to achieve most effective results without any side effects it is better to avoid alcohol.
Do not stop taking Diamox suddenly.
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Sleep apnea syndrome is estimated to affect as many as 2 to 3 percent of the adult male population. Excessive snoring and daytime sleepiness are but a few of the many clues to diagnosis. The hypoxemia occurring as a result of apnea may lead to pulmonary hypertension. Depressed respiratory center neural output or upper airway occlusion during sleep may cause the apnea. There are a number of treatment options available.
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The examination time may be reduced from 50 min to 45 min or 40 min as needed. The rate of increase was not influenced by the time frame for determination or the timing of ACZ administration. These findings suggest that our estimation method is accurate and versatile.
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The role of serosal bicarbonate ions (HCO3-) in protection against acid injury was investigated in rabbit esophageal mucosa mounted in Ussing chambers. Luminal acidification reduced potential difference and resistance in tissues exposed serosally to HCO3- or (unbuffered) HCO3-free solution. Whereas resistance declined similarly in both groups, potential difference declined less in HCO3- solution. After washout, HCO3-bathed tissues also had a greater increase in resistance, lower permeability to mannitol, and less histologic damage. Furthermore, as protection by HCO3- was not blocked by pretreatment with either the anion exchange blocker, 4 acetamido-4'-isothiocyanatostilbene 2-2'-disulfonic acid, or the carbonic anhydrase inhibitor, acetazolamide, and replacement of HCO3- with N-2-hydroxyethylpiperazine-N'-2-ethane sulfonic acid, a buffer impermeant to cells, was protective, an extracellular site for protection by HCO3- was likely. Where in the extracellular space HCO3- buffers H+ is unclear, but the absence of change in luminal pH and the inability to prevent the acid-induced increase in permeability in HCO3-bathed tissues argue against a luminal (preepithelial) site. Also, rapid repair was not demonstrated, indicating that a luminal site for protection after surface cell damage was unlikely. We conclude that serosal HCO3- is important in esophageal protection against acid damage by buffering H+ within the intercellular compartment of the extracellular space.
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A female patient presented with horizontal gaze nystagmus, mild cerebellar ataxia, recurrent headache and hemiplegia since childhood with cerebellar atrophy on magnetic resonance imaging. Genetic analysis revealed a CACNA1A gene mutation, leading to a diagnosis of familial hemiplegic migraine (FHM1). FHM is very rare, but should be considered as a differential diagnosis for childhood cerebellar symptoms and/or cerebellar atrophy. To avoid missing FHM1, a detailed clinical history including headache or hemiplegia is essential. Oral acetazolamide during the aura phase, comprising mild headache and abnormal leg sensation, relieved these symptoms in this patient, suggesting that acetazolamide could represent a first line of treatment.
In an eight-week study, timolol maleate ophthalmic solution 0.25% was administered twice daily with either pilocarpine 2% four times a day, epinephrine 2% twice a day, carbachol 1.5% four times a day, or 250 mg of acetazolamide twice a day to 44 patients with chronic open-angle glaucoma. Compared to baseline readings on standard therapy alone, mean intraocular pressure was significantly reduced after addition of timolol maleate to each of the regimens. Mean facility of outflow was unaffected. No clinically significant ocular irritation or changes in visual acuity, pupil size, or vital signs were observed in any patient. Timolol maleate appears to be effective and well tolerated when administered with other antiglaucoma medications in patients with open-angle glaucoma.
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Our previous results suggested that elevated LDL was protective while an inflammatory response was contributory with respect to AMS development. The present results suggest that statin use may provide protection against AMS symptoms, possibly through an anti-inflammatory property, despite its lipid-lowering capacity. Harrison MF, Johnson BD. Statin use and the development of acute mountain sickness.
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To evaluate the performance of 6-O-Lauryl-l-ascorbic acid nanostructures (coagels) as vehicles for acetazolamide (AZM) in ophthalmic administration by in vitro and in vivo experimental tests.
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Accurate assessment of medication adherence is critical for determination of medication efficacy in clinical trials, but most current methods have significant limitations. This study tests a subtherapeutic (microdose) of acetazolamide as a medication ingestion marker because acetazolamide is rapidly absorbed and excreted without metabolism in urine and can be noninvasively sampled.
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Best-corrected visual acuity (BCVA) at initial and last visit.
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1. The I.V. injection of sodium salicylate (100 mg/kg) in the dog caused a rapid and maintained choleresis of the order of 300-600 percent of control levels. 2. The total amount of salicylate excreted in bile was only 1-2 percent of that injected. 3. The secretion of bile salt into bile was not increased by salicylate. 4. The choleresis caused by salicylate was associated iwth a decrease in the concentrations of sodium and of bile salt in bile, and with an increase in the concentration of chloride; the biliary concentration of bicarbonate was either temporarily increased or unchanged. 5. The choleresis could not be inhibited by the intra-portal injection of of ouabain (0-1 mg/kg). 6. The secretion of bromsulphthalein into bile was not potentiated by the choleresis. 7. The choleretic efficiency of sodium taurocholate was not increased in the presence of salicylate. 8. The injection of acetazolamide (20 mg/kg) in the presence of a salicylate choleresis, caused an increase in the osmolaity of bile and an increase in biliary sodium concentration, such that the composition of bile more nearly approached that of plasma. 9. The possible mechanisms underlying the choleretic effect of sodium salicylate are discussed.
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Alkaline secretion was measured in the whole stomach and in the proximal duodenum (2 cm proximal to the outlet of the common bile duct) of anesthetized rats, under basal conditions and in response to topical acid and 16,16-dimethyl PGE2 (16-dmPGE2) given by various routes. Gastric alkaline secretion was unmasked by intraduodenal administration of omeprazole (30 mg/kg). Both the stomach and duodenum consistently secreted bicarbonate in amounts of 0.2-0.4 microEq/15 min and 1.5-2 microEq/15 min as a basal secretion, respectively. 16-dmPGE2, either given subcutaneously (1-30 micrograms/kg), intravenously (3 micrograms/kg/hr) or by topical application for 30 min (0.3-10 micrograms/ml), (concentration)-dependently increased HCO3- secretion in both tissues, but this effect disappeared quickly after sacrifice with KCI (i.v.). Stimulation of HCO3- secretion was also caused by topical acid to the stomach (100 mM HCI for 10 min) or to the duodenum (10 mM HCI for 10 min), but was completely blocked by pretreatment with indomethacin (5 mg/kg, s.c.). Acetazolamide, given subcutaneously at 100 mg/kg, which gives over 80% inhibition of carbonic anhydrase activity in the gastroduodenal mucosa, had no effect on either basal or stimulated HCO3- secretion caused by 16-dmPGE2 (10 micrograms/kg, s.c.). These results indicate that both endogenous and exogenous (16-dmPGE2) prostaglandins stimulate alkaline secretion in the gastroduodenal mucosa of rats, and this mechanism is independent from the carbonic anhydrase activity of the tissue.
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The experiments reported in this paper were designed to evaluate some of the characteristics of anion transport processes during fluid absorption from superficial proximal straight tubules isolated from rabbit kidney. We measured net chemical C1- flux during fluid absorption from tubules perfused and bathed with Krebs-Ringer buffers containing 113.6 mM C1-, 10 mM acetate, and 25 mM HCO-/3 at pH 7.4; assessed the effects of carbonic anhydrase inhibitors on net fluid absorption in the presence and absence of CO2; and evaluated the influx and efflux coefficients for [14C]-acetate transport at 37degreesC, at 21degreesC, and in the presence of carbonic anhydrase inhibitors. The experimental data shown that, for this nephron segment, net C1- flux accompanies approximately 27.5% of net Na+ absorption; and net C1- absorption may be accounted for by a passive transport process, primarily diffusional in nature. Fluid absorption in this nephron segment is reduced 40-60% by carbonic anhydrase inhibitors, but only when the tubules are exposed to 95% O2-5% CO2 rather than 100% O2. Thus, it seems probably that approximately half of Na+ absorption in these tubules may be rationalized in terms of a carbonic anhydrase-dependent CO2 hydration process. In addition, there may occur in these isolated proximal tubules an acetazolamide-insensitive moiety of HCO-/3 absorption comparable to that observed for proximal tubules in vivo. Finally, we provide evidence that net efflux of luminal acetate is due to metabolic energy-dependent processes other than CO2 hydration and may, under appropriate conditions, account for approximately one-fourth of net Na+ absorption.
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This study showed that the sequential use of acetazolamide tablets and dorzolamide eye drops should be considered and studied further as a possible treatment for macular edema and visual impairment in patients with RS1 from a hemizygous p.Arg197Cys mutation.
The effects of putative water channel blockers were tested on AQP1-expressing Xenopus laevis oocytes by a fast optical method with a time resolution of 1 s and a volume resolution of 20 pl. The oocytes were exposed to external hyposmolarity and the osmotic water permeability (Lp) derived from the initial 10 s of volume change. For longer durations, the effective osmotic gradient across the membrane was reduced significantly because of dilution of the intracellular contents and of ion transport across the membrane. The latter was monitored by voltage clamp of the oocytes. In contrast to previous reports based on slower and less sensitive assays, we found no effects of tetraethylammonium ions (TEA+) and acetazolamide on Lp. We have no single explanation for this, but several factors are considered: (a) If the osmotic gradient is assumed to be constant for periods longer than 10 s, the Lp will be underestimated. (b) Hyposmotic gradients implemented by dilution with water will entail changes in the ionic strength as well; this may enhance loss of salt from the oocyte. (c) By voltage clamping the AQP1-expressing oocytes during hyposmotic challenges, we found that TEA+-treated oocytes were more electrically leaky than untreated ones. This may obscure comparisons between the Lp of treated and untreated oocytes. (d) The nature of the ion transport mechanisms in the plasma membrane depends on how oocytes have been prepared for experiments and on their viability as indicated by the membrane potential. These parameters may vary between laboratories.
To highlight concepts critical to achieving successful repair and avoiding intracranial complications in the treatment of cerebrospinal fluid (CSF) leaks from the lateral recess of the sphenoid sinus (LRS).
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The electrometric [Delta]pH method and an in vitro radioisotopic HCO3- dehydration assay were used to demonstrate the presence of true extracellular carbonic anhydrase (CA) activity in the blood of the Pacific spiny dogfish Squalus acanthias. An extracorporeal circulation and stopflow technique were then used to characterise the acidbase disequilibrium in the arterial (postbranchial) blood. During the stopflow period, arterial pH (pHa) decreased by 0.028±0.003 units (mean ± s.e.m., N=27), in contrast to the increase in pHa of 0.029±0.006 units (mean ± s.e.m., N=6) observed in seawater-acclimated rainbow trout Oncorhynchus mykiss under similar conditions. The negative disequilibrium in dogfish blood was abolished by the addition of bovine CA to the circulation, while inhibition by benzolamide of extracellular and gill membrane-bound CA activities reversed the direction of the acidbase disequilibrium such that pHa increased by 0.059±0.016 units (mean ± s.e.m., N=6) during the stopflow period. When the CA activity of red blood cells (rbcs) was additionally inhibited using acetazolamide, the magnitude of the negative disequilibrium was increased significantly to -0.045±0.007 units (mean ± s.e.m., N=6). Blockage of the rbc Cl-/HCO3- exchanger using 4,4'-diisothiocyanostilbene-2,2'-disulphonic acid (DIDS) also increased the magnitude of the negative disequilibrium, in this case to -0.089±0.008 units (mean ± s.e.m., N=6). Exposure of dogfish to hypercapnia had no effect on the disequilibrium, whereas the disequilibrium was significantly larger under hypoxic conditions, at -0.049±0.008 units (mean ± s.e.m., N=6). The results are interpreted within a framework in which the absence of a positive CO2 excretion disequilibrium in the arterial blood of the spiny dogfish is attributed to the membrane-bound and extracellular CA activities. The negative disequilibrium may arise from the continuation of Cl-/HCO3- exchange in the postbranchial blood and/or the hydration of CO2 added to the plasma postbranchially. Two possible sources of this CO2 are discussed; rbc CO2 production or the admixture of blood having 'low' and 'high' CO2 tensions, i.e. the mixing of postbranchial blood with blood which has bypassed the respiratory exchange surface.
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Thirteen patients in whom extensive craniectomies had been performed underwent a meticulous study of blood flow velocities in the middle cerebral artery (MCA) and extracranial internal carotid artery (ICA), as assessed by transcranial Doppler ultrasonography during postural maneuvers (supine and sitting positions) and during stimulation with 1 g of acetazolamide for the interpretation of CVR capacity. Twelve patients underwent 18-fluorodeoxyglucose positron emission tomography. These measurements were obtained before and 7 days after cranioplasty. Cranioplasty improved preoperative differences in MCA blood flow velocities when comparing those in the injured with those in the uninjured hemisphere. Similarly, cranioplasty resolved decreases in extracranial ICA blood flow in the injured hemisphere that were induced by postural changes, which was a constant finding prior to this procedure. More strikingly, however, the CVR capacity, which was severely impaired in both hemispheres, increased significantly after the procedure. Metabolic deficits, which were observed in the injured hemisphere, were found to improve after reimplantation of the skull bone flap.
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Several trials have asserted that some anticonvulsant drugs seem to be useful for the prophylaxis of migraine, but systematic reviews are sparse. We independently searched PubMed, EMBASE and the Cochrane Central Register of Controlled Trials until 2005, as well as Headache and Cephalalgia through April 2006, for prospective, controlled trials of anticonvulsant drugs. Data were calculated and pooled across studies and expressed as standardized mean differences, odds ratios and numbers-needed-to-treat. Anticonvulsants, considered as a class, reduce migraine frequency by about 1.3 attacks per 28 days compared with placebo, and more than double the number of patients for whom migraine frequency is reduced by > or = 50% relative to placebo. Sodium valproate/divalproex sodium and topiramate were better than placebo, whereas acetazolamide, clonazepam, lamotrigine and vigabatrin were not; gabapentin, in particular, needs further evaluation. Trials designed with sufficient power to compare different drugs are also necessary.
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Combination AZ + SFN treatment induced dose-dependent suppression of growth, produced a potent anti-proliferative and anti-clonogenic effect, and induced apoptosis through caspase-3 and PARP activation. The anti-proliferative effect was corroborated by significant reductions in Ki-67, pHH3, cyclin D1, and sustained induction of the cell cycle inhibitors, p21 and p27. Both active p-Akt (Ser473) and p-S6 were significantly downregulated in the AZ + SFN combination treated cells with a concomitant inhibition of Akt kinase activity. The inhibitory effects of the AZ + SFN combination treatment showed similar efficacy as the dual PI3K/mTOR pathway inhibitor NVP-BEZ235, albeit at an expected higher dose. In terms of the effect on the metastatic potential of these bladder cancers, we found downregulated expression of carbonic anhydrase 9 (CA9) concomitant with reductions in both E-cadherin, N-cadherin, and vimentin proteins mitigating the epithelial-to-mesenchymal transition (EMT), suggesting negation of this program.
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The chemosensitive area on the ventral surface of the brain stem responds to local acidosis by eliciting hyperventilation and to local alkalosis by hypoventilation. The stimulus is conventionally thought to be the hydrogen ion concentration in the area's extracellular fluid. It is pointed out, however, that the elegant studies by Loeschcke & Ahmad have demonstrated that [pH]e and [pH]i are normally tightly and rapidly coupled (Loeschcke & Ahmad, 1980). For this reason, the stimulus might just as well be the intracellular hydrogen ion concentration in the chemoreceptor area. The administration of acetazolamide allows the dissociation of [pH]e from [pH]i. With acetazolamide a sharp acid shift of CSF pH [( pH]c) is measured and in two consonance with this shift a marked increase in CBF is seen. Comparing these two reactions to that obtained with CO2 breathing, it is apparent that 7% CO2 causes about the same decrease in [pH]e and the same increase in CBF. In other words CBF acidosis can quantitatively account for the CBF increase induced by acetazolamide. But CO2 and acetazolamide influence [pH]i quite differently, as CO2 drops [pH]i to almost the same extent as [pH]c, while two recent studies by MR spectroscopy have shown that acetazolamide does not drop [pH]i measurably, if tissue hypercapnia is prevented in artificially ventilated rabbits or by the mild spontaneous hyperventilation caused by acetazolamide in normal man.(ABSTRACT TRUNCATED AT 250 WORDS)
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Vasoreactivity is reduced in peripheral arteries and in intracranial arteries in patients with CADASIL.
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The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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The relationships between inhibition of carbonic anhydrase (CA) activity in cytoplasmic, microsomal, and myelin subcellular fractions obtained from cerebral cortex, subcortex, and cerebellum and electroshock seizure threshold (EST) and modification of the extension/flexion (E/F) ratio following maximal electroshock seizures (MES) were ascertained in Swiss-Webster mice given 40 and 200 mg/kg acetazolamide. The parameters were determined at 1, 4, and 24 h after administration of acetazolamide. The results showed that changes in the E/F ratio induced by acetazolamide correlated linearly (r = 0.90) with changes in CA activity in the cytoplasm of the subcortex. However, there was an inverse power function correlation (r = 0.92) between EST and CA activity in the myelin fraction of the cerebral cortex. The time course of acetazolamide inhibition of CA activity in these two fractions also paralleled the time course of its effects on EST and E/F ratio. Thus, acetazolamide decreases susceptibility to seizures (raises EST) by inhibiting myelin CA and prevents spread of seizure activity by inhibiting CA in the cytoplasm of glial cells. The CO2 that accumulates as a result of CA inhibition in these two fractions causes profound changes in brain function.
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Most horses testing homozygous for HPP had clinical signs associated with pharyngeal and laryngeal dysfunction. Hyperkalemic periodic paralysis should be included on a differential list for horses examined for signs of laryngeal or pharyngeal dysfunction or stridor. Treatment with acetazolamide may help to control respiratory tract signs associated with this disease.
Sixteen eyes of 15 consecutive patients presenting with clinical ME 1-120 months after ophthalmologic surgery were studied retrospectively. The mean duration of ME before treatment was 5 months. All patients were treated with 250-500 mg of acetazolamide per day, associated with topical NSAIDs and/or steroids for an average of 6.9 months. The main outcome measures were the best-corrected visual acuity expressed in Log MAR, and the retinal thickness evaluated with OCT.
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To determine whether beta-adrenergic blocker (beta-blocker) therapy for glaucoma causes changes in the trabecular meshwork due to underperfusion.
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When late replantation is performed, the root surface and root canal should be treated. Notwithstanding failures still occur, because of the high rates of root resorption, evidencing the need to search for substances that may inhibit root resorption. The acetazolamide is a known anti-resorptive agent, and its use as root canal dressing may increase the success rates in the treatment of root resorption. Therefore, this study evaluated the effect of an acetazolamide paste used as root canal dressing in late replanted teeth. The study was conducted on 24 maxillary right incisors of rats, which were avulsed and divided in two groups. In group I, the teeth were kept dry for 30 min, had their root surfaces rubbed with a blade, and were treated with 2% sodium fluoride at pH 5.5 for 20 min; the root canals were instrumented and filled with acetazolamide paste; and then the teeth were replanted. In group II, the treatment was similar to group I, except for the root canal dressing, with utilization of calcium hydroxide in group II. At 15 and 60 days after replantation, the animals were killed and the specimens were processed in a histotechnical laboratory for microscopic and morphometric analysis. The results demonstrated the ability of both intracanal substances to limit root resorption, yet they were unable to completely inhibit the root resorption. Replacement resorption lacunae were present in greater proportion in group II, at 60 days. It was concluded that the acetazolamide paste was effective to limit the root resorption, being more effective in limiting the replacement resorption compared with calcium hydroxide.
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We conclude that a single 500-mg dose of acetazolamide reverses nonchloride responsive metabolic alkaloses in medical intensive care unit patients as effectively as multiple doses of 250 mg. Studies to examine the prolonged duration of action of acetazolamide observed in this study as well as the effect of acetazolamide on clinical end points, such as duration of mechanical ventilation, are warranted.
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