Zolamide-250mg

Acetazolamide A to Z Drug Facts Acetazolamide Action Indications Contraindications Route/Dosage Interactions Lab Test Interferences Adverse Reactions Precautions Patient Care Considerations Administration/Storage Assessment/Interventions Patient/Family Education (uh-seet-uh-ZOLE-uh-mide) Diamox, Diamox Sequels, Ak-Zol, Dazamide, Acetazolam, APO-Acetazolamide, Diamox, Novo-Zolamide Class: Anticonvulsant/carbonic anhydrase inhibitor Action Inhibits carbonic anhydrase enzyme, reducing rate of aqueous humor formation and thus lowering IOP; produces diuretic effect; retards neuronal conduction in brain. Indications Adjunctive treatment of chronic simple (openangle) glaucoma and secondary glaucoma; preoperative treatment of acute congestive (closed-angle) glaucoma; prevention or lessening of symptoms associated with acute mountain sickness; adjunctive treatment of (1) edema caused by CHF or drug-induced edema and (2) centrencephalic epilepsies (eg, petit mal, generalized seizures). Contraindications Hypersensitivity to other sulfonamides; depressed sodium or potassium serum levels; marked kidney and liver disease or dysfunction; suprarenal gland failure; hyperchloremic acidosis; adrenocortical insufficiency; severe pulmonary obstruction with increased risk of acidosis; cirrhosis; long-term use in chronic noncongestive angle-closure glaucoma. Sustained release dosage form is not recommended for use as anticonvulsant or for treatment of edema caused by CHF or drug-induced edema. Route/Dosage Epilepsy ADULTS & CHILDREN: 8 to 30 mg/kg/day in divided doses; optimum range 375 to 1000 mg daily. When drug is given in combination with other anticonvulsants, initial dosage is 250 mg once daily. Chronic Simple (Open-Angle) Glaucoma ADULTS: PO 250 mg to 1 g/day, usually in divided doses for amounts > 250 mg. Secondary Glaucoma/Preoperative Treatment of Closed-Angle Glaucoma ADULTS: SHORT-TERM CARE: PO 250 mg q 4 hr or 250 mg bid. ACUTE CARE: PO Initially 500 mg; then 125 to 250 mg q 4 hr. IV therapy may be used for rapid relief of increased IOP. Direct IV administration is preferred because IM route is painful. CHILDREN: ACUTE CARE: IM/IV 5 to 10 mg/kg/dose q 6 hr. LONG-TERM CARE: PO 10 to 15 mg/kg/day in divided doses q 6 to 8 hr. Diuresis in CHF ADULTS: PO Initially 250 to 375 mg (5 to 10 mg/day) q AM; then give on alternate days or for 2 days alternating with 1 day of rest. Drug-Induced Edema ADULTS: PO 250 to 376 mg qd for 1 to 2 days. CHILDREN: PO/IV 5 mg/kg q AM. Most effective if given every other day or for 2 days alternating with 1 day of rest. Acute Mountain Sickness ADULTS: PO 500 to 1000 mg/day in divided doses. Interactions Diflunisal: May cause significant decrease in IOP. Primidone: Primidone concentrations may be decreased. Quinidine: Quinidine serum levels may be increased. Salicylates: May cause acetazolamide accumulation and toxicity, including CNS depression and metabolic acidosis. Lab Test Interferences False-positive urinary protein results may occur because of alkalinization of urine. Adverse Reactions CNS: Drowsiness; confusion; sensory disturbances, including paresthesia and loss of appetite; convulsions. DERM: Skin rash; urticaria. EENT: Transient myopia; photosensitivity; hearing disturbances; sore throat. GI: Nausea; vomiting; diarrhea; melena. GU: Polyuria; hematuria; glycosuria. HEMA: Blood dyscrasias, including agranulocytosis and aplastic anemia; unusual bleeding or bruising. HEPA: Hepatic insufficiency. OTHER: Flaccid paralysis; fever; flank or loin pain; severe adverse reactions associated with sulfonamides, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Precautions Pregnancy: Category C. Lactation: Undetermined. Dose increases: Increasing dose does not augment diuresis but may increase drowsiness and paresthesias. Pulmonary conditions: Use in pulmonary obstruction and emphysema may aggravate or precipitate acidosis. PATIENT CARE CONSIDERATIONS Administration/Storage Administer with food. Tablets can be crushed and mixed with sweet foods to mask bitter taste. Do not crush sustained-release capsules; open and sprinkle contents on food. To prevent dehydration, give patient 2000 to 3000 ml/day of fluids, unless contraindicated. Store in a cool, dry location at room temperature. Assessment/Interventions Obtain patient history, including drug history and any known allergies. Assess baseline CBC and platelet count before initiating therapy. Monitor at regular intervals. If medication is being used as diuretic, monitor weight and I&O throughout therapy. Monitor electrolyte levels throughout therapy. Take appropriate seizure precautions. Observe for signs of sulfonamide allergy and toxicity (eg, fever, rash, fluid retention). Check for signs of hypokalemia (eg, low serum potassium levels, muscle weakness, cardiac arrhythmia) and metabolic acidosis (eg, confusion, drowsiness, lethargy, headache, abdominal pain, cardiac arrhythmia, Kussmaul respirations). In patients with glaucoma, monitor IOP frequently. Notify physician immediately if patient develops increased difficulty in breathing or signs of toxicity (eg, drowsiness, anorexia, nausea, vomiting, dizziness, paresthesia, ataxia, tremor, tinnitus). Notify physician if the following signs occur: Sore throat, fever, unusual bleeding or bruising, tingling or tremors in hands or feet, loin pain, or skin rash. Patient/Family Education Advise patient to take medication with food to decrease gastric irritation and upset. Instruct seizure patients not to stop taking medication suddenly because doing so can cause seizures. Caution patient to avoid sudden or rapid position changes to prevent orthostatic hypotension. Advise patient to eat foods high in potassium and to avoid black licorice. Caution patient about possible temporary difficulty with far vision. Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness. Encourage patient to carry medical ID card or wear Medi-Alert bracelet if taking drug for control of seizures. Instruct patient not to take any otc medications without consulting physician. Books@Ovid Copyright © 2003 Facts and Comparisons David S. Tatro A to Z Drug Facts