Carbonic Anhydrase Inhibitors
Mechanism Of Action :
Inhibition of carbonic anhydrase enzyme
Inhibition of bicarbonate ion formation in aqueous
Reduced Na2+ in ciliary body
Reduced H2O absorption
Reduced aqueous formation
Duration of Action : 6-8 hours
Frequency : QID
- Short term : all types of acute & chronic glaucoma
- Long term : reserved for patients at high risk of visual loss, where all other treatment fails.
- Prophylaxis : intra ocular surgery
SIDE EFFECTS :
- Paresthesia of fingers, toes, hands, feet & around the mouth – hence it is ALWAYS PRESCRIBED with electrolyte rich items:
- BANANA – contra indicated in diabetics
- COCONUT WATER
- SYRUP POT CHLOR (Potassium Chloride ) : if above two are not available.
- Urinary frequency due to diuretic effect
- Serum electrolyte imbalance :
- Bicarbonate depletion : malaise, fatigue, loss of libido, anorexia & weight loss
- K+ depletion : especially in those taking steroids too.
- G.I.T. : abdominal discomfort, gastric irritation, nausea, metallic taste & diarrhea
- Sulfonamide related side effects : S-J syndrome, renal calculi, blood dyscrasias, transient myopia, HT nephropathy, teratogenic.