Diamox is an FDA-approved medication used to treat certain types of glaucoma, congestive heart failure, certain types of seizures. Diamox also prevents altitude sickness.
Other names for this medication:
Also known as: Acetazolamide.
Diamox contains an active ingredient Acetazolamide, which belongs to class of drugs called carbonic anhydrase inhibitors.
Diamox effectively treats certain types of glaucoma (excessive pressure in the eyes) by reducing the amount of fluid in the eye, and thereby decreases pressure inside the eye.
Acetazolamide acts also as a diuretic ("water pill") and inhibits the protein in the body called carbonic anhydrase. This leads to reducing the build-up of certain fluids in the body, significantly alleviating the symptoms of congestive heart failure.
Acetazolamide is also used to treat certain types of seizures, and to treat or prevent altitude sickness.
Diamox is available in tablets.
The dosage depends on the disease and its prescribed treatmen.
250 mg to 1 gram per 24 hours in 2 or more smaller doses.
In secondary glaucoma and before surgery in acute congestive (closed-angle) glaucoma, the usual dosage is 250 mg every 4 hours or, in some cases, 250 mg twice a day.
The daily dosage is 8 to 30 mg per 2.2 pounds of body weight in 2 or more doses. Typical dosage may range from 375 to 1,000 mg per day.
Congestive Heart Failure treatment:
The usual dosage is 250 mg to 375 mg per day or 5 mg per 2.2 pounds of body weight, taken in the morning.
Diamox can be used by children.
If you want to achieve most effective results do not stop taking Diamox suddenly.
If you overdose Diamox and you don't feel good you should visit your doctor or health care provider immediately.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.
The most common side effects associated with Diamox are:
Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.
Do not take Diamox if you are allergic to Diamox components.
Be careful with Diamox if you're pregnant or you plan to have a baby, or you are a nursing mother.
Do not take Diamox if your sodium or potassium levels are low.
Do not take Diamox if you have kidney or liver disease, including cirrhosis.
Be careful with Diamox if you suffer from or have a history of emphysema or other breathing disorders.
Be careful with Diamox if you take high doses of aspirin.
Be careful with Diamox if you are taking Amitriptyline, Cyclosporine, Lithium, Methenamine, oral diabetes drugs such as Glyburide, Quinidine.
Do not use potassium supplements or salt substitutes.
If you want to achieve most effective results without any side effects it is better to avoid alcohol.
Do not stop taking Diamox suddenly.
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The study comprised 12 patients (5 men and 7 women, age 35.1 years ± 14.7), with 21 hemispheres with the diagnosis of moyamoya disease. During the period 2005-2009, the patients underwent initial and follow-up technetium-99m ethyl cysteinate dimer (Tc-99m ECD) single photon emission computed tomography (SPECT). The 3DSRT was applied to estimate regional CBF at rest and CVR. Time-course changes in CBF and CVR in a region of the middle cerebral artery were analyzed, considering the presence or absence of an ischemic event and revascularization surgery.
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The transcranial Doppler is a suitable method for detecting altered cerebral hemodynamics in significant carotid stenosis. Impaired cerebrovascular reactivity may refer to the impairment of cerebral autoregulatory mechanisms.
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rCBF values of normally perfused segments were 41.53 and 51.91 mL/100 g/min for pre- and post-acetazolamide (123)I-IMP studies, respectively. Corresponding values for pre- and post-acetazolamide FAIR images, respectively, were 46.64 and 59.60 mL/100 g/min with a TI of 1200 milliseconds and 53.23 and 68.17 mL/100 g/min with a TI of 1400 milliseconds. (123)I-IMP and FAIR results were significantly correlated, with both pre- and post-acetazolamide images. Sensitivity (86%) in detecting hypoperfused segments was significantly higher with post-acetazolamide images (TI, 1400 milliseconds), and specificity (82-85%) and accuracy (80-82%) were higher with all pre- and post-acetazolamide images (all TIs).
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setting: Institutional. patients: Fifteen patients with CME and RP. intervention: A baseline visual acuity and optical coherence tomography (OCT) measurements were obtained in all patients. Each one of them was then treated with topical dorzolamide, three times a day, for at least four weeks in both eyes. main outcome measures: Significant decrease in "foveal thickness" (more than 16%) and "foveal zone thickness" (more than 11%), as measured by OCT.
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Between days 9.5 and 10, the forelimb buds of developing murine embryos progress from stage 1 which are just beginning to express shh and whose posterior mesoderm has only weak polarizing activity to stage 2 limbs with a distinguishable shh expression domain and full polarizing activity. We find that exposure on day 9.5 to teratogens that induce the loss of posterior skeletal elements disrupts the polarizing activity of the stage 2 postaxial mesoderm and polarizing activity is not subsequently restored. The ontogeny of expression of the mesodermal markers shh, ptc, bmp2, and hoxd-12 and 13, as well as the ectodermal markers wnt7a, fgf4, fgf8, cx43, and p21 occurred normally in day 9.5 teratogen-exposed limb buds. At stage 3, the treated limb apical ectodermal ridge usually possessed no detectable abnormalities, but with continued outgrowth postaxial deficiencies became evident. Recombining control, stage matched limb bud ectoderm with treated mesoderm prior to ZPA grafting restored the duplicating activity of treated ZPA tissue. We conclude that in addition to shh an early ectoderm-dependent signal is required for the establishment of the mouse ZPA and that this factor is dependent on the posterior ectoderm.
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The role of HCO3-/CO2 buffer in Cl- absorption was examined in the in vitro perfused eel intestine adapted to seawater. Cl- absorption, expressed as short-circuit current (Isc), was measured in either 20 mM HCO3-/1% CO2 Ringer or HEPES Ringer, pH 8.0. Unilateral (mucosal or serosal) substitution of HCO3-/CO2 with HEPES/O2 was without effect on Isc and transepithelial voltage (Vt), whereas bilateral removal of HCO3-/CO2 reduced Isc and Vt by 50%, indicating that the presence of HCO3-/CO2 buffer at one side of the epithelium is sufficient to keep Cl- absorption at the maximum rate. We examined in further detail the individual components of the HCO3-/CO2 system that stimulates Cl- absorption. We found that, in tissues bathed with HEPES Ringer, addition of 1% CO2 to the luminal or serosal solution (final pH = 7.6 in the chamber) had no effect on Isc and Vt, while both electrical parameters could be restored to control values by unilateral (luminal or serosal) substitution of HEPES Ringer with 20 mM HCO3-/1% CO2 Ringer or 20 mM HCO3- alone. Stimulation of Isc induced by unilateral (luminal or serosal) HCO3-/CO2 was inhibited by luminal or serosal 4-acetamido-4'-isothiocyanostilbene-2,2'-disulphonic acid (SITS) (0.25 mM) or by serosal Na+ removal, whereas amiloride (1 mM), luminal or serosal, had no effect. Acetazolamide (0.1 mM, both sides) inhibited stimulation of Isc induced by luminal addition of HCO3-/CO2, whereas it was without effect when HCO3-/CO2 was added serosally or bilaterally.(ABSTRACT TRUNCATED AT 250 WORDS)
Pregnant C57BL/6J mice were treated with 0 or 50 mg of caffeine (CAFF) per kg, and 0, 200 mg/kg (L) or 1,000 mg/kg (H) of acetazolamide (ACZM) during day 9 of gestation (9DPC). Individual fetuses were examined for gross morphological abnormalities and skeletal variations. The increase in fetal malformations seen, especially right forelimb electrodactyly, was augmented at both dose levels of acetazolamide by concomitant exposure to caffeine. Both frequency and severity of ectrodactyly were potentiated by caffeine. Skeletal examination revealed a reduction of the number of ossified cervical and caudal vertebral centra among litters exposed to ACZM at either dose. In either case (ACZM-H, ACZM-L) that effect was augmented by co-administration of CAFF. The first cervical vertebra (C1) appeared to provide the most sensitive index of teratogenic exposure. This study provides evidence that a subteratogenic dose of caffeine can potentiate the teratogenic effect of acetazolamide in C57BL/6J mice when dams are treated on day 9 of gestation. In addition, skeletal examination provided evidence that simultaneous treatment with both agents delayed fetal development. Many litters exposed to ACZM or both agents displayed a reduction in skeletal ossification even in the absence of gross morphological abnormalities, suggesting that ossification can be used as an indicator of prenatal exposure to potentially harmful substances in the C57BL/6 mouse strain.
This prospective study included 75 patients with moyamoya disease, including 28 children and 47 adults. We performed STA-MCA anastomosis and EDMAPS on 123 hemispheres of 75 patients. In addition to conventional STA-MCA anastomosis and indirect bypass for the MCA territory, the medial frontal lobe was revascularized using the frontal pericranial flap through medial frontal craniotomy. Surgical results were analyzed with magnetic resonance imaging, cerebral angiography, and single-photon emission computed tomography/positron emission tomography.
The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery.
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A 38-year-old hemophiliac, who had been infected with HIV by the administration of blood products and had been diagnosed as AIDS by the onset of Pneumocystis carinii pneumonia, was admitted to our hospital with the complaints of headache and vomiting. After he was diagnosed as cryptococcal meningitis using the microscopy, cryptococcal antigen detection and culture of cerebrospinal fluid, treatment with amphotericin-B and fluconazole was started. As there was no clinical improvement, spinal drainage was performed and acetazolamide administered in order to reduce the intracranial pressure. Treatment was changed from AMPH-B and FLCZ to a combined therapy of AMPH-B and itraconazole. As his clinical features showed improvement, he was discharged home on a maintenance dose of ITCZ and acetazolamide after having been hospitalized for three months. This case-report may be of use in the management of cryptococcal meningitis in patients with AIDS.
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Studying chemical control of ventilation implies evaluation of both chemoreceptor functions taken into account however the mechanical factors influencing the effector organs. The role of abnormal chemical drives has been demonstrated in COPD patients. More recently the role of abnormal chemical drives was studied during sleep. Absent or severely depressed drives may facilitate the development of central apneas and hypoventilation. High drives may lead to periodic breathing eventually with central apneas as well. Most intriguing therefore is the role of chemical drives in the pathogenesis of the obstructive and central sleep apnea syndrome. There is accumulating evidence that fluctuations in the drive to breathe may adversely affect the upper airway patency and facilitate upper airway closure and obstructive apneas. Interaction with chemical drives (eg by administration of acetazolamide) has been shown to improve central (and eventually also obstructive) sleep apnea. Studying chemical drives will probably be clinically useful in solving the complex mechanisms controlling ventilation during sleep in patients with and without underlying airway or lung disease.
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A 35-bed medical intensive care unit in a tertiary care teaching hospital.
We report the case of a 24-year-old woman with HIV-seropositivity, who developed a clinical picture of pseudotumor cerebri, an association not previously described. The patient improved with the use of acetazolamide. We suggest the possible existence of this disorder in HIV-infected patients with persistent headaches, visual deficits and/or extraocular muscle palsies.
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Data were extracted using standardised forms and analysed using Rev Man 4.2.7 software.
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None of the patients with severe defects underwent sacrifice of the carotid. Both tests resulted in increased security regarding the prediction of possible brain perfusion damage. The combination of angiography and brain scintigraphy is logistically easy and has a high value of prediction.
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This overview discusses pathogenesis, clinical presentation, prognostic implications and therapy of central sleep apnea with special reference to Cheyne-Stokes-Respiration or periodic breathing. In contrast to obstructive sleep apnea due to upper airway collapse during sleep, central sleep apnea (CSA) is mainly due to an instability of the breathing control system. Causes of central sleep apnea include alveolar hypoventilation disorders, heart failure, neurologic and autonomic disorders and idiopathic forms of CSA. Patients with idiopathic CSA often complain of insomnia and awakening during sleep but may also suffer from daytime sleepiness. Cheyne-Stokes-Respiration or peridic breathing is often associated with heart failure and neurological disorders especially those involving the brainstem. In heart failure periodic breathing has enormous prognostic implications. Treatment options for central sleep apnea are oxygen supplementation, medical therapy (i.e. acetazolamide) and CPAP. For patients with central sleep apnoea associated with alveolar hypoventilation nasal ventilation is treatment of choice. Newer nasal ventilation techniques (BiPAP, AutoSetCS) are under investigation for heart failure patients with Cheyne-Stokes-Respiration.
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Using 99mTc-HMPAO alone, a bilateral hypoperfusion was found in the temporal and/or parietal regions in 33% (6/18) of VD patients and in 70% (23/33) of AD patients. The vascular reserve capacity, as determined with the acetazolamide test, was not impaired in 22% of the VD patients but in 76% of the AD patients. The differences in the perfusion patterns between VD and AD patients were statistically different (p < 0.01, Fischer's exact test). Of the 6 VD patients with hypoperfusion (bilateral temporal and/or parietal), 4 had a decreased vascular reserve capacity as determined in the acetazolamide test. Decreased reserve capacity was found in only 4 out of 25 patients with AD.
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Tetracycline injection (45 mg/kg, i.v.) produced increases in plasma urea and creatinine levels in rats. The greatest increases occurred after 24 hr for urea and after 6 hr for creatinine, the latter effect persisted for at least 30 hr. The actions of six diuretics (acetazolamide, bumetanide, chlorothiazide, chlorthalidone, triamterene and indapamide) given orally either as pretreatment (1 hr before tetracycline injection) or post-treatment (4 hr after tetracycline injection) were examined. When given as pretreatments, all six diuretics reduced the hyperuraemia, and generally the hypercreatininaemia, that existed 24 hr after tetracycline injection. In contrast, when given as post-treatments, only bumetanide reduced the increase in urea and creatinine levels. It is postulated that this protective action of diuretics could occur by their displacement of tetracycline molecules from protein binding sites or by a-direct action on renal function.
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This pilot study was undertaken in lowlanders, during their ascent from 2600 m to 3500 m, to evaluate the effects of Acetazolamide and Dexamethasone on Cardio-Respiratory parameters and Exercise Capacity. 40 unacclimatised low-landers were divided into 2 groups. Subjects of Group 'A' were given Acetazolamide and Dexamethasone and those of Group 'B' were given Acetazolamide and placebo. 8 subjects matched for age, physical fitness, height and weight were randomly selected from each study group and were evaluated for their Exercise Capacities. Both study groups showed significant rise in Heart Rate, Respiratory Rate and a significant fall in Systolic Blood Pressure. There was no difference in Exercise capacities achieved by subjects of two groups at 3500 m.
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The steady-state CO(2) flux across thin layers of 30 g/100 ml albumin solutions was measured in two different CO(2) partial pressure ranges (boundary PCO(2) values 3 and 8 torr, and 160 and 650 torr, respectively). From the data the apparent diffusion coefficient for CO(2), DCO(2), was calculated. In the high PCO(2) range a value of DCO(2) was found which is to be expected on the basis of diffusion of dissolved CO(2) only. In the low PCO(2) range DCO(2) was about 100% higher than in the high PCO(2) range, when carbonic anhydrase was present and the pH was approximately 7.7. DCO(2) depended on the concentration of carbonic anhydrase. It increased with increasing pH. It is concluded that an additional diffusion of bound CO(2) (facilitated CO(2) diffusion) occurs in the low PCO(2) range and that this transport involves the hydration of CO(2). From the diffusion coefficients in the two PCO(2) ranges the rate of facilitated diffusion was determined. Approximate calculations show that this rate (at pH = 7.7) can be explained on the basis of the proposed mechanism of facilitated CO(2) diffusion: bicarbonate diffusion and simultaneous proton transport by albumin diffusion. The view that facilitated CO(2) diffusion is mediated by the diffusion of albumin is supported by the experimental finding of a considerable suppression of the facilitated CO(2) flux in the presence of gelatinized agar-agar.
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No deaths and no strokes occurred. Four complications were seen. In the first 30 patients with computed tomography scans, 20 had positive SPECT scans, whereas the computed tomography scan was negative. A 100% linear correlation was seen with operative stump pressures, and decreased regional cerebral blood flow was noted on SPECT scan before surgery (48 abnormal with mean 26 mm). These patients received shunts during CEA.
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Headaches and papilloedema are key features of idiopathic (benign) intracranial hypertension (IIH). We describe three children in whom IIH was diagnosed in the absence of papilloedema. Recognition of atypical cases of IIH is important because pressure lowering treatment may be effective.
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The distribution of 99mTc-HMPAO is linearly related to rCBF measured by 133Xe SPECT, although our data suggest that 99mTc-HMPAO mildly underestimates rCBF above 80 ml/min/100 g. These results are similar to our previous comparison of 99mTc-ECD and 133Xe.
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Studying the kinetics of reversible protein-small molecule binding is a major challenge. The available approaches require that either the small molecule or the protein be modified by labeling or immobilization on a surface. Not only can such modifications be difficult to do but also they can drastically affect the kinetic parameters of the interaction. To solve this problem, we present kinetic size-exclusion chromatography with mass spectrometry detection (KSEC-MS), a solution-based label-free approach. KSEC-MS utilizes the ability of size-exclusion chromatography (SEC) to separate any small molecule from any protein-small molecule complex without immobilization and the ability of mass spectrometry (MS) to detect a small molecule without a label. The rate constants of complex formation and dissociation are deconvoluted from the temporal pattern of small molecule elution measured with MS at the exit from the SEC column. This work describes the concept of KSEC-MS and proves it in principle by measuring the rate constants of interaction between carbonic anhydrase and acetazolamide.
The acetazolamide (ACZ) test is performed to evaluate the decrease in cerebral perfusion pressure (CPP) by investigation of vasomotor reactivity (VMR). Our aim was to study cerebral blood flow and blood volume changes induced by the ACZ test in healthy control subjects using dynamic susceptibility contrast-enhanced gradient-echo MRI (DSC-MRI). A FLASH sequence was used to produce susceptibility-weighted images during an intravenous injection of 0.1 mmol/kg gadopentetate dimeglumine (Gd-DTPA). After the first dynamic study, 1 g acetazolamide was given intravenously and 10 min later a second bolus of Gd-DTPA was injected. Using the indicator-dilution theory, relative cerebral blood volume and relative cerebral blood flow were estimated. In healthy subjects the ACZ test induced a significant increase in relative blood volume (from 80.5 +/- 10.7 to 113.4 +/- 11.9) and relative blood flow (from 5.73 +/- 0.96 to 7.5 +/- 0.97), symmetrically in the cerebral hemispheres. This approach might be promising in the understanding of cerebral haemodynamics in patients with vascular disorders.
1. Patterns of carbon dioxide excretion were investigated in rainbow trout (Salmo gairdneri). 2. The loss of erythrocytic carbonic anhydrase caused by severe anaemia does not affect acid/base regulation or the ability of fish to excrete CO2. 3. Bicarbonate excretion across the saline-perfused gills of trout is significant even though residence time for the saline in the gills is only 1--3 s. CO2 excretion across these saline-perfused gills is blocked by the carbonic anhydrase inhibitor, diamox. 4. The excretion of CO2 in fish is via the movement of plasma bicarbonate into the gill epithelium where branchial carbonic anhydrase catalyses the production of CO2. Fish can adjust pH by regulating bicarbonate movement across the gills. 5. The erythrocytic carbonic anhydrase is not necessary for CO2 excretion in the gills but is involved in facilitating Bohr and Root shifts to augment O2 delivery in the tissues.
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