Carbonic Anhydrase Inhibitors1 Orange

Mechanism of Action: Inhibition of carbonic anhydrase decreases aqueous production in ciliary body; when given parentally, will also dehydrate the vitreous.

Side Effects: Local (with Topical Therapy): Bitter taste.

Systemic (with Topical Therapy): Diuresis, fatigue, GI upset, Stevens-Johnson syndrome, theoretical risk of aplastic anemia.

(with Systemic Therapy): Hypokalemic/acidosis, renal stones, paresthesias, nausea, cramps, diarrhea, malaise, lethargy, depression, impotence, unpleasant taste, aplastic anemia, Stevens-Johnson syndrome.

Contraindications: Sulfa allergy, hyponatremia/kalemia, recent renal stones, thiazide diuretics, digitalis use

Drug

Trade

Concentration

Usual Dose

Notes acetazolamide brinzolamide dorzolamide

Diamox

Diamox Sequels

Azopt Trusopt

125, 250mg tabs 500mg caps 500mg IV 5-lOmg/kg/dose

QD-QID QD-BID one dose PO TID-QID

BID-TID BID-TID

Onset within 2hr, lasts 4-6 hr lasts 12-24 hr

Immediate onset, duration 4 hr for temporary IOP control Infantile glaucoma;

definitive treatment is surgical. For preparation Instructions, see Appendix 2. TID for single therapy TID for single therapy BID when used in combination with beta blockers

Cosopt see notes methazolamide Neptazane, MZM, Glauctabs 25, 50 mg tabs 1 For listing of preservatives of anti-glaucoma medications, refer to Appendix 5.

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