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
Notes acetazolamide brinzolamide dorzolamide
125, 250mg tabs 500mg caps 500mg IV 5-lOmg/kg/dose
QD-QID QD-BID one dose PO TID-QID
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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