Acetazolamide (Diamox)

Question 1

Drug Class

Acetazolamide

Answer 1

Carbonic anhydrase inhibitor, diuretic

Question 2

Mechanism of Action

Acetazolamide

Answer 2

Inhibits hydrogen ion (H) excretion in renal tubules, increasing sodium, potassium, bicarbonate, and water excretion and producing alkaline diuresis

Question 3

Indications and Contraindications

Answer 3

Indications: AMS (treatment and prophylaxis), prevention of HACE

Contraindications: Known hypokalemia, hyponatremia, renal dysfunction, renal dysfunction, liver dysfunction. Should not be used for treatment of High Altitude Pulmonary Embolism (HAPE)

Question 4

Side Effects & Interations

Answer 4

Side Effects: Fluid and electrolyte imbalance, metabolic acidosis, seizures, nausea, vomiting, anorexia, orthostatic hypotension

Interactions: Increased risk of severe acidosis, CNS toxicity with high dose aspirin. Caution with diuretics and anticonvulsants. Can potentiate effects of hypoglycemics.

Question 5

Dosage and Administration

Answer 5

Adult: Treatment of AMS: 250mg orally every 12 hours

Pediatric: Treatment of AMS: 2.5mg/kg orally every 12 hours

Question 6

Duration of Action

Answer 6

Onset: 1-1.5 hours, Peak: 2-4 hours, Duration: 4-12 hours

Question 7

Special Considerations

Answer 7

Pregnancy Category C, can be used as an adjunct to dexamethasone in HACE treatment, but dexamethasone remainds primary treatment for HACE