乙酰唑胺片说明书

【别名】 醋氮酰胺;醋唑磺胺;代马克司 ,乙酰唑胺 ,丹木斯,代冒克斯, 醋氮酰胺
【外文名】Acetazolamide ,Acetamide, Albox,Diluran, Diurramide, DIAMOX, Edemox
【适应症】
用于心脏性水肿，但对肾脏性及肝性水肿无效。亦用于治疗脑水肿和消化性溃疡病和青光眼。

【药品名称】
通用名:乙酰唑胺片
曾用名:醋氮酰胺片、醋唑磺胺片
商品名:Diamox
英文名: Acetazolamide Tablets
汉语拼音:Yixianzuo’an Pian
本品主要成分及其化学名称:
主要成分:乙酰唑胺
化学名称:N-[5-(氨磺酰基) -1,3,4-噻二唑-2-基]乙酰胺
分子式与分子量: C4H6N4O3S2
分子量:222.25
其结构式为:

【性状】
本品为白色片
【药理毒理】
本品为碳酸酐酶抑制剂,能抑制房水生成,降低眼压.房水流出易度则不改变.乙酰唑胺能抑制睫状体上皮碳酸酐酶的活性,从而减少房水生成(50％～60％),使眼压下降
【药代动力学】
口服容易吸收.与蛋白结合率高.口服乙酰唑胺500mg后1～1.5小时降低眼压作用开始；2～4小时血药浓度达峰值；可维持4～6小时,血清最高浓度为12～27mg/ml,T1/2为2.4～5.8小时.乙酰唑胺口服,在24小时内给药量的90％～100％以原形由肾脏排泄
【适应症】
适用于治疗各种类型的青光眼,对各种类型青光眼急性发作时的短期控制是一种有效的降低眼压的辅助药物
开角型(慢性单纯性)青光眼,如用药物不能控制眼压,并用本品治疗可使其中大部分病例的眼压得到控制,做为术前短期辅助药物
闭角型青光眼急性期应用本品降压后,原则上应根据房角及眼压描记情况选择适宜的抗青光眼手术
本品也用于抗青光眼及某些内眼手术前降低眼压.抗青光眼术后眼压控制不满意者,仍可应用本品 控制眼压
继发性青光眼也可用本品降低眼压
【用法与用量】
成人常用量:(1)开角型青光眼,口服首量250mg(1片),每日l～3次,维持量应根据病人对药物的反应决定,尽量使用较小的剂量使眼压得到控制；一般每日2次,每次 250mg(1片)就可使眼压控制在正常范围.(2)继发性青光眼和手术前降眼压,口服250mg(1片),每4～8小时 1次,一般每日2～3次.(3)急性病例,首次药量加倍给500mg(2片),以后用125～250mg(0.5～1片)维持量,每日2～3次
【不良反应】
一般用药后常见的不良反应有:
(1)四肢麻木及刺痛感；
(2)全身不适症候群:疲劳、体重减轻、困倦抑郁、嗜睡、性欲减低等；
(3)胃肠道反应:金属样味觉、恶心、食欲不振、消化不良、腹泻；
(4)肾脏反应:多尿、夜尿、肾及泌尿道结石等
(6)可出现暂时性近视,也可发生磺胺样皮疹,剥脱性皮炎
少见的副作用:
(1)电解质紊乱:代谢性酸中毒、低钾血症,补充碳酸氢钠及钾盐有可能减轻症状；
(2)听力减退；
(3)最严重的不良反应是造血系统障碍:急性溶血性贫血、粒细胞减少症、血小板减少症、嗜伊红细胞增多症、再生障碍性贫血,和肾功能衰竭
长期用药可加重低钾血症、低钠血症、电解质紊乱及代谢性酸中毒等症状.由于血钾下降可减弱本品的降眼压作用.对肾结石病人,本品可诱发或加重病情,如出现肾绞痛和血尿应立即停药
【禁忌症】
肝、肾功能不全致低钠血症、低钾血症、高氯性酸中毒,肾上腺衰竭及肾上腺皮质机能减退(阿狄森病),肝昏迷
【注意事项】
(1) 询问病人有否磺胺过敏史,不能耐受磺胺类药物或其他磺胺衍生物利尿药的患者,也不能耐受本品
(2)与食物同服可减少胃肠道反应
(3)下列情况应慎用:
①因本品可增高血糖及尿糖浓度,故糖尿病患者应慎用；
②酸中毒及肝、肾功能不全者慎用
(4)对诊断的干扰:
①尿17—羟类固醇测定,因干扰Glenn—Nelson法的吸收,可产生假阳性结果；
②尿蛋白测定,由于尿碱化,可造成如溴酚蓝试验等一些假阳性结果；
③血氨浓度、血清胆红素、尿胆素元浓度都可以增高；
④血糖浓度、尿糖浓度均可增高,非糖尿病者不受影响；
⑤血浆氯化物的浓度可以增高,血清钾的浓度可以降低
(5)随访检查:急性青光眼及青光眼急性发作时,每日应测眼压,慢性期应定期测量眼压,并定期检查视力、视野.眼压控制后应根据青光眼类型、前房角改变及眼压描记情况,调整用药剂量及选择适宜的抗青光眼手术.需延期施行抗青光眼手术的病人,较长期使用本品,除应加服钾盐外,在治疗前还需有24小时有眼压、视力、视野、血压、血象及尿常规等记录,以便在治疗过程中评价疗效及发现可能产生的不良反应,根据病情调整药量
(6)某些不能耐受乙酰唑胺不良反应或久服无效者,可改用其他碳酸酐酶抑制剂,如双氯非那胺
【孕妇及哺乳期用药】
动物试验证实应用高于成人剂量10倍的乙酰唑胺对啮齿类动物胎仔有较高的致畸发病率,因此必需考虑其利弊.已有报告指出将要分娩的和妊娠期的妇女不宜使用,尤其是妊娠的前3个月内哺乳妇女确需使用本品应暂停哺乳
【儿童用药】
小儿常用量:抗青光眼,每日2～3次,每次按体重口服5～10mg／kg,或每日按体表面积口服300～900mg/m2,分2～3次服用
【老年患者用药】
【药物相互作用】
(1)与促肾上腺皮质激素、糖皮质激素尤其与盐皮质激素联合使用,可以导致严重的低血钾,在联合用药时应注意监护血清钾的浓度及心脏功能.亦应估计到长期同时使用有增加低血钙的危险,可以造成骨质疏松,因为这些药都能增加钙的排泄
(2)与苯丙胺、抗M—胆碱药、尤其是和阿托品、奎尼丁联合应用时,由于形成碱性尿,本品排泄减少,会使不良反应加重或延长
(3)与抗糖尿病药(如胰岛素)联合应用时,可以减少低血糖反应,因为本品可以造成高血糖和尿糖,故应调整剂量
(4)与苯巴比妥、卡马西平或苯妥英等联合应用,可引起骨软化发病率上升
(5)洋地黄苷类与本品合用,可提高洋地黄的毒性,并可发生低钾血症
(6)与甘露醇或尿素联合应用,在增强降低眼内压作用的同时,可增加尿量
【药物过量】
尚未有患者服用过量致急性毒性反应的报道
【规格】
0.25g

【药物剂型】片剂

【生产厂商】上海医药(集团)有限公司信谊制药总厂

提示：国内没货，欧美国家有货，如需紧急需要，可以协助购买

英文药名: Diamox (Acetazolamide Tablets)

中文药名: 醋氮酰胺（乙酰唑胺片）

250mg 100片

我院有少量货

Diamox

Diamox (Acetazolamide) and generic diamox

Pharmacological action

Causes weak diuretic effect. Preparation application at the raised intracranial pressure is bound to suppression carboangidraiz in plexuses of ventricles of a brain and depression of production of a spinno-brain liquid.
Duration of action - to 12 h.

Indications

- A hydropic syndrome (weak and moderate degree of expression, in a combination to an alkalosis);
- A glaucoma (primary and secondary, and also at an acute attack);
- An epilepsy (as a part of the combined therapy);
- An intracranial hypertensia;
- Acute high-rise (mountain) illness (a preparation reduces acclimatisation time, but its action on illness symptoms is expressed slightly).

Dosage regimen

At a hydropic syndrome in the beginning of treatment the preparation is prescribed in a dose by of 250-375 mg (1-1 tabltes.) 1 time/sut in the morning. The maximum diuretic effect is reached at preparation reception in day or 2 days on end, and then - an one-day break. At Diamox application it is necessary to continue circulatory unefficiency therapy, including warm glycosides, to keep to a diet with restriction of consumption of salt and to compensate for the deficiency a potassium.
The adult at an open angle glaucoma the preparation is prescribed in a single dose by of 250 mg (1 tablet.) 1-4 times/days of the Dose exceeding 1 g, do not enlarge therapeutic effect. At a secondary glaucoma the preparation is prescribed in a single dose by of 250 mg (1 tablet) everyone 4 h. At some patients the therapeutic effect is shown after short-term reception of a preparation on 250 mg 2 times/days At acute attacks of a glaucoma a preparation prescribe on 250 mg 4 times/days
To children at attacks of a glaucoma Diamox is prescribed in a dose from calculation of mass of a body by of 10-15 mg/kg a day for 3-4 receptions.
At an epilepsy the adult prescribe on 250-500 mg/sut in one step within 3 days, to 4th day - a break. To children is elderly with 4 to 12 months 50 mg/sut in 1-2 receptions; 2-3 years - 50-125 mg/24h in 1-2 receptions; 4-18 years on 125-250 mg of 1 times/24h in the morning. At simultaneous application of Diamox with other anticonvulsant preparations in the treatment beginning apply 250 mg (1 tablet) 1 time/24h, if necessary gradually enlarging a dose. At children it is not necessary to apply the doses exceeding 750 mg/days
At a mountain disease recommend to apply a preparation in a dose of 500-1000 mg (2-4 tablets) a day; in case of a fast ascension - on 1000 mg/days the Daily dose divide into some receptions in peer doses. The preparation should be applied for 24-48 h before an ascension, and in case of occurrence of symptoms of illness - to continue treatment during the following 48 h or more if it is necessary.
At the admission of reception of a preparation it is not necessary to enlarge a dose at the next reception.

Side effect

From party TSNS and peripheric nervous system: cramps, paresthesias, an anorexia, a sonitus, short-sightedness; at long application - a disorientation, touch disturbance, drowsiness.
From hemopoiesis system: on occasion at long application - a hemolitic anaemia, a leukopenia, an agranulocytosis.
From vodno-electrolytic balance and acid-alkaline balance: a hypopotassemia, a metabolic acidosis.
From the alimentary system: an anorexia; at long application - a nausea, vomiting, a diarrhoeia.
Dermatological reactions: seldom - reddening of integuments, an itch.
The other: seldom - muscular delicacy, allergic reactions.

Contraindications

- Acute renal insufficiency;
- Hepatic insufficiency;
- A cirrhosis;
- A hypopotassemia;
- An acidosis;
- A hypocorticoidism;
- An uremia;
- A diabetes;
- Pregnancy;
- A lactemia;
- A hypersensibility to preparation components.

Pregnancy and lactemia

Diamox is contraindicative to application at pregnancy and in a lactemia.

Special indicatings

With care prescribe a preparation at edemas of a hepatic and renal genesis and at joint reception with Acidum acetylsalicylicum.
At appointment of a preparation more than 5 days raise risk of development of a metabolic acidosis on end.
With care it is necessary to apply a preparation at elderly patients and-or patients with disturbances of function of kidneys because of the raised risk of development of a metabolic acidosis.
The control of laboratory indicators
At long application of a preparation it is necessary to supervise a picture of peripheric blood, indicators of vodno-electrolytic balance and an acid-alkaline exchange.

Overdosage

Symptoms: intensifying of the described by-effects is possible.
Treatment: spend symptomatic therapy.

Medicinal interaction

At joint application with antiepileptic preparations Diamox strengthens osteomalacia implications.

Conditions and periods of storage

The preparation should be stored in dry, protected from light and a place inaccessible to children at temperature not above 25 C. The Period of validity - 5 years.

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