Posts Tagged ‘acetazolamide’

Type of Drug
Carbonic-Anhydrase Inhibitors,
Eyedrops (kar-BON-ik an-HYE-drase)
Brand Names
Generic Ingredient: Dorzolamide Trusopt
Generic Ingredient: Brinzolamide Azopt
Combination Product
Generic Ingredients: Dorzolamide + Timolol Cosopt
Prescribed For  Glaucoma.
General Information
These drugs are similar to acetazolamide, a carbonic-anhydrase inhibitor taken by mouth. Carbonic anhydrase is an enzyme found in many parts of the body, including the eyes. By blocking the effects of this enzyme, dorzolamide and brinzolamide slow the production of fluid inside the eye, reducing pit:ssure. This cffc,, i3 usetul in ir83t
ino, open-angle glaucoma because the disease is characterized by elevated eye pressure. Dorzolamide and brinzolamide are sulfonamides, or sulfa drugs, and although they are administered topically, they affect the body systemically.
Cautions and Warnings
Do not use these drugs if you are allergic or sensitive to any of their ingredients or to other sulfa drugs. Small amounts of these drugs enter the bloodstream. Rarely, people using them experience side effects or allergies associated with sulfa drugs.
These drugs have not been studied in people with very poor kidney or liver function. Since these drugs are eliminated via the kidneys, people with impaired kidney function should use an alternate glaucoma medication.
These drugs have not been studied in people with acute angle-closure glaucoma.
See Timolol, page 1129, for more information on the combination product Cosopt.
Possible Side Effects
Dorzolamide
✓    Most common: eye burning, stinging, or discomfort and a bitter taste in the mouth immediately after administering the eyedrops.
✓    Less common: allergic reactions, conjunctivitis (pinkeye), blurred vision, tearing, dry eye, and increased sensitivity to bright light.
♦    Rare: headache, nausea, weakness, tiredness, rash, and kidney stones. Dorzolamide can cause the same types of side effects as other sulfa drugs, but this is very unlikely. Contact your doctor if you experience any side effects not listed above.
Brinzolamide
♦    Common: blurred vision and a bitter, sour, or unusual taste in the mouth.
♦    Less common: eyelid inflammation; conjunctivitis (pink-
eyeY, nsh; dry eye; sensation of something in the eye;
headache; eye redness, itching, discharge, or pain; and
runny nose.
✓    Rare: allergic reactions, hair loss, chest pain, diarrhea, nausea, sore throat, tearing, itchy rash, double vision, dizziness, Possible Side Effects (continued)
dry mouth, breathing difficulties, upset stomach, tired eyes, kidney pain, cornea problems, and formation of a crust or sticky sensation around the eyelid. Brinzolamide can cause the same types of side effects as other sulfa drugs, but this is very unlikely. Contact your doctor if you experience any side effect not listed above.
Drug Interactions
• If you are using more than 1 eyedrop product, separate doses of these drugs by at least 10 minutes.
Usual Dose
Adult: 1 drop in the affected eye 3 times a day. Overdosage
Accidental ingestion of a bottle of dorzolamide or brinzolamide may affect blood levels of potassium and other electrolytes. The victim should be taken to a hospital emergency room. ALWAYS bring the prescription bottle or container.
Special Information
Call your doctor and stop using your eyedrops if you develop any unusual eye reaction or condition, including swollen eyelids and conjunctivitis (pinkeye).
Vision may be temporarily blurred when using the eyedrops. Use caution when driving or operating machinery.
If you wear soft contact lenses, take them out before using the eyedrops and put them back in 15 minutes after a dose.
To prevent infection, do not allow the eyedropper tip to touch your fingers, eyelids, or any surface. Wait at least 10 minutes before using any other eyedrops.
If you forget to administer a dose, do so as soon as you remember. If it is almost time for your next dose, skip the one you forgot and continue with your regular schedule. Do not take a double dose.
Special Populations
Pregnancy/Breast-feeding: Very high dosages of dorzolamide or brinzolamide caused birth defects in animal studies. While the risks of using these drugs during pregnancy are small in people, pregnant women should use dorzolamide or brinzolamide only after discussing its potential benefits and risks with their doctors.
it is not known if these drugs pass into breast milk. Nursing mothers who must use either drug should use infant formula.
Seniors: Seniors may be more sensitive to side effects.

carbon dioxide A colourless, non-inflamniable gas. It has a stimulating effect on the respiratory centre, and a mixture of 5% of carbon dioxide in oxygen is used for respiratory depression. Solid carbon dioxide is used to destroy warts, naevi, etc.
carbonic anhydrase inhibitors These drugs, represented by acetazolamide and dichlorphenamide, have been used as diuretics as they inhibit the reabsorption of sodium and bicarbonate in the kidneys. Their use has declined as more effective diuretics have become available. They also reduce the formation of the aqueous humour and so bring about a reduction in the iruraticular pressure, and are used in the treatment of glaucoma. See page 138 and Table 16.
carboplatin An analogue of cisplatin but with generally reduced side-effects, although the myelodepression may be more severe. It is used mainly in ovarian and small-cell lung cancer.
Dose: 40 nighn’ i.v. as a single dose, repeated after 4 weeks. Blood tests during treatments are essential. Severe renal impairment is a contraindication. ( Pai aplatin). See page 122 and Table 8.
carboprost A prostaglandin with a selective action oil the myornetrium, and used in post-partum haemorrhage not responding to ergometrine.
Dose: 250 pg initially by deep i.m. injection, with subsequent doses according to need up to a total of 2 mg (not for i.v. injection). Care in asthma, epilepsy and hypertension. Nausea and vomiting are side effects. (Hemabate).
carisoprodol A muscle relaxant used in niusculoskeletal disorders and muscle spasm.
Dose: I g daily. (Carisomi).
carmustine A cytoxic agent similar to 1-viustine. It is used mainly in brain tumours, multiple myeloma and Hodgkin’s disease, often in association with other drugs.
Dose: 200 rnghii2 by slow i.v, injection, repeated at intervals of 6 weeks. Side-effects are nausea, vomiting and burning at the injection site. A delayed bone-marrow depression is often a dose-limiting factor. (BICNU). See page 122 and Table 8.
Cef
carteolof A beta-adrenaergic blocking agent used as eye drops (0.1-0.2%) in glaucoma. Some systemic absorption may occur from eye drops, and care is necessary in asthma and bradycardia. (Teoptic). See page 138.
carvedilol A non-cardiac selective betablocker with the actions and uses of propanolol.
Dose: in hypertension 12.5 mg initially, rising to 25-50 mg as a single daily dose. (hucardic). See page 148 and Table 21.
cascara A mild purgative.
Dose: dry extract 100-250 nig, liquid extract and elixir 2-5 nil.
castor oil A mild purgative.
Dose: 5-20 nil. The oil has emollient properties and is used together with zinc ointment for pressure sores and napkin rash.
catecholamines A term applied to the synipathornimetic drugs adrenaline, dopamine, noradrenaline, and related compounds, indicating that they are derivatives of catechol.
CCNU See lomustine.
cefaclor An orally active cephalosporin antibiotic used mainly in urinary and respiratory infections.
Dose: 750 ing or more, up to 4 g daily, with reduced doses in renal impairment. Nausea and diarrhoea are side-effects, but all allergic reaction indicating sensitivity may require withdrawal of the drug. (Distaclor). SeeTable 34,
cefadroxil An analogue of cephalexin. It is well absorbed orally and gives high blood levels.
Dose: 1-2 g daily, (Baran), See page 248 and Table 34.
cefatnandole See cephamandole.
cefixime A cephalosporin with the actions, uses and side-effects of the cephalosporins generally, but effective in single daily doses of 200-400 mg. (Suprax). See page 248 and Table 34.
cefodizine A cephalosporin used in lower respiratory tract infections and in urinary tract infections.
Dose: 2 g (laity by i.m. injection or i.v.

Cefotaxime A cephalosporin with an ink reased activity against many Gram-negative organisms.
Dose: 2 g daily by injection, increased in severe infections tip to 12 g daily. A single dose of 1 g is given in gonorrhoea. The side-effects are those of the cephalosporins generally. (Claforan). See page 248 and Table 34.
cefoxitin A cephaniycin with a wide range of activity and an increased potency against Gram-negative bacteria. It is of value in many infections, and is also used in surgical prophylaxis.
Dose: 3-12 g daily by Lin. or i.v. injection. (NIefoxin). See page 248 and Table 34.
cefp1ronve A beta -lactaniase- stable cephalosporin with a wide range of activity. Dose: 2 g daily i.v. (Cefrom). See
page 248 and Table 34.
cefuroxime A cephalosporin often effective against some organisms resistant to penicillin, and with increased activity
against Haemophilus inflidenzae.    27 Dose: 3-6 g daily by injection. For surgical prophylaxis and in gonorrhoea a single dose of 1.5 g. Side-effects include nausea, diarrhoea, urticaria, rash and hypersensitivity reactions. (Zinacef). cefuroxime-axetil is an orally active form. Dose: 500 mg- I g daily. (Zinnat). See page 248 and fable 34.
celiprolol A selective 0, receptor blocking agent, with some stimulating action oil receptors. The former occur mainly in the heart, the latter in the bronchi and peripheral vessels. It is used in mild hypertension, as it has a vasodilatory and cardioselective action with reduced side-effects.
Dose: 200 mg daily, at breakfast. Occasional side-effects are nausea, headache and dizziness. (Celectol). See page 148 and Table 21.
ceflaodoxime An oral cephalosporin for respiratory tract infections.
Dose: 200-400 mg daily with food. (Orelox). See page 248 and Table 34.
ceftazidime A cephalosporin resistant to most beta-lactamases, and active against a wide range of Gram-positive and Gram-negative organisms, including Pseudomonas aeruginosa, although it is less active against Staphylococcus aureus. Valuable in both single and mixed infections.
Dose: 1-6g daily by injection, reduced in cases of renal impairment. In pseudontonal lung infections associated with cystic fibrosis, 1(4-150nit
g/kg daily. Side-effects include abdominal disturbance and local reactions at the injection site. (FortUol; Ket”adirn). See page 248 and Table 34.
cettibuten An oral cephalosporin similar to cefaclor, but with a longer action. Dose: 400 nigas a single daily (lose. (Cedax t. See page 248 and Table 34.
ceftriaxone A cephalosporin of the cefaclor
Jtype given as a single daily dose of I g by eep i.m. or slow i.v. injection, doubled in severe infections. With high doses vary injection site. (Rocephin). See page 248 and Table 34.
cephalexin An orally active cephalosporin Of value in infections of the respiratory and urinary tracts, and in naso-oral and soft-tissue infections.
Dose: 1-2 g daily, but lower (loses are indicated in renal impairment. Cephalexin is usually well tolerated, but sonic gastrointestinal disturbances may occur. (Ceporex; Kellex). See page 248 and Table 34.
cephalosporins A group of antibiotics with properties similar to those of the penicillins, but having a wider range of activity. Some are active orally, others may have to be given by injection.
Cefotaxime, ceftazidime and ceftizoxime have an increased activity against Gram-negative bacteria, but are less potent against Staphylococcus aureus and Gram-positive organisms generally. Cefititoxin is active against bowel organisms. An indication of the range and dose is given in the table on page 248. The higher doses are given in severe infections; reduced doses should be given in renal impairment. The main side-effect of the cephalosporins is hypersensitivity, and cross- sensitivity to the penicillins is not uncommon. Sensitivity to one is likely to extend to all members of the group. The cephalosporins call affect blood-clotting mechanisms.