利尿药乙酰唑胺ACETAZOLAMIDE
本品为N-(5-氨磺酰基-1,3,4-噻二唑-2-基) 乙酰胺
Acetazolamide推荐用于治疗成人任何程度的急性高山心脏病（AMS）症状。虽然和严重的急性高山心脏病未必有有很大差别，不过仍应该服用。如果只是为了提高改善睡眠，治疗轻微AMS的剂量为125mg，在睡前服用。对于中等到严重的急性高山心脏病，一天2次，每次250mg，直到患者好转。副作用有小便增多，手脚、嘴唇附近麻痹或者刺痛，反胃，有喝碳酸饮料的感觉。有一些人对于这些副作用无法接受，不能容忍这种药品。作为一种磺胺类药品，磺胺过敏者不能使用。虽然对小孩是安全的，但是目前没有小孩在高海拔使用的经验。对于轻微到中等AMS，acetazolamide和不提升睡觉地点的海拔一起使用。在其他场合，它是辅助的，其他的治疗是必需的。 　　
利尿剂Acetazolamide（乙酰唑（磺）胺，醋唑磺胺，利尿剂）对预防高山心脏病是很有用的，特别是对AMS（急性高山反应），被FDA（美国食品及药物管理局）认可用于此目的。服用此药导致生理性反应使你呼吸更快，加快适应。它不会掩盖症状，如果你已经有了高山心脏病，它不会保护你，从而使你继续攀登。Acetazolamide帮助身体排泄新陈代谢中由二氧化碳产生的bicarbonate（重碳酸盐），使血液运氧量更多更快。推荐高海拔的人和在海拔10000英尺（3050m）以上，一天睡觉地点海拔差达到或者超过2000英尺（610m）登山者使用。它对在之前场合得过高山心脏病的人会有帮助。对于大多数从海平面到美国山区海拔作短暂滑雪的人，不推荐使用。
一般与其他药品配合治疗某些类型的青光眼。它也用于治疗或预防高山病的症状。也可用于医生确诊的其他病症。它降低了眼球的流体压力，从而减小眼球的压力。
Acetazolamide不具有魔力，不能立刻治愈高山心脏病。它只是使身体需要24到48小时的适应过程缩短到12到24小时。　　

剂量：125mg（把250mg的药品掰成两片），一天两次。尽管比以前推荐的剂量要小，125mg可能和更多的剂量效果是一样的，和250mg相比小便损失的水分更少，副作用更小。在同一海拔一到两天后可以停止服用。一般的副作用是手指、脚趾、嘴唇附近的皮肤有麻刺的感觉，频繁小便（充当利尿剂），有喝碳酸饮料的感觉。Acetazolamide是磺胺类药剂，磺胺过敏者不能使用。小孩使用效果没有数据，你可以尝试2-5mg/kg，一天两次。 　　

药品学名：Acetazolamide，Dichlorphenamide，Methazolamide等。 　　
品牌名称：Acetazolam，Ak-Zol，Apo-Acetazolamide，Daranide，Dazamide，Diamox，DiamoxSequels，Neptazane等，最常用的称呼是Diamox．它是磺胺类药物，对磺胺过敏者或肝肾功能不好者等别用。 　　
　　
副作用：有麻木感，刺痛感，手、脚、唇的震颤，口中变味，耳鸣等。这些在停用药物后会消失。因为Acetazolamide会强迫排泄碳酸根，所有你在用药期间将会尿频。不经常发生的副作用有恶心，头疼。一些登山者在只服用此药一到两片后视线变得非常模糊，幸运的是当他们停止服用几天时间后，视线就恢复了。 　　
不建议将Acetazolamide作为一种预防药物，下列有限的几种特殊情况例外。大多数有合理的上升计划的人都不需要它，而且除了一些小但令人讨厌的副作用外，它还可能具有磺胺类药物的严重副作用。

Acetazolamide在下列条件下可以使用： 　　
——治疗患高山心脏病的人 　　
——治疗被夜里的间歇呼吸困扰的人 　　
——对那些短时间内被迫上升很多的人 　　
——对那些过去患过多次高山心脏病的人

香港注册编号：HK-36263

GENERIC NAME: Acetazolamide

Brand Name: APO-Acetazolamide

What is Acetazolamide and for what Acetazolamide is used?
Acetazolamide medication belong to Anticonvulsant/Carbonic anhydrase inhibitor class.

Acetazolamide is used to prevention or lessening of symptoms associated with acute mountain sickness (tablet only); adjunctive treatment of chronic simple (open-angle) glaucoma and secondary glaucoma; preoperative treatment of acute congestive (closed-angle) glaucoma; adjunctive treatment of 1) edema caused by CHF or drug-induced edema and 2) centrencephalic epilepsies (eg, petit mal, generalized seizures).

How to Take Acetazolamide
Take Acetazolamide exactly as prescribed by health care provider. Acetazolamide is avaliable in form of Tablets and oral form.

Dosage Instructions for Acetazolamide Drug
Adults:  PO 325 to 650 mg prn q 4 to 6 hr or 1 g 3 to 4 times/day. Do not exceed 4 g/day.
Children:  PO 10 to 15 mg/kg dose prn q 4 to 6 hr; do not exceed 5 doses/24 hr.

Contraindications of Acetazolamide
Hypersensitivity to other sulfonamides; depressed sodium and/or potassium serum levels; marked kidney and liver disease or dysfunction; suprarenal gland failure; hyperchloremic acidosis; adrenocortical insufficiency; severe pulmonary obstruction with increased risk of acidosis; cirrhosis; long-term use in chronic noncongestive angle-closure glaucoma. Sustained release dosage form is not recommended for use as anticonvulsant or for treatment of edema caused by CHF or drug-induced edema.

Interactions of Acetazolamide with other drugs
Diflunisal: May cause significant decrease in IOP.
Primidone: Primidone concentrations may be altered.
Quinidine: Quinidine serum levels may be increased.
Salicylates: May cause acetazolamide accumulation and toxicity, including CNS depression and metabolic acidosis.

What are the Side Effects of Acetazolamide -
Like other medicines, Acetazolamide can cause side effects. Some of the more common side effects of Acetazolamide include

Drowsiness; confusion; sensory disturbances, including paresthesia and loss of appetite; convulsions.
Skin rash; urticaria.
Transient myopia; hearing disturbances; sore throat; tinnitus.
Nausea; vomiting; diarrhea; melena; taste alterations.
Polyuria; hematuria; glycosuria.
Blood dyscrasias, including agranulocytosis and aplastic anemia; unusual bleeding or bruising
Hepatic insufficiency; fulminant hepatic necrosis.
Metabolic acidosis; electrolyte imbalance.
Flaccid paralysis; fever; flank or loin pain; severe adverse reactions associated with sulfonamides, including Stevens-Johnson syndrome and toxic epidermal necrolysis; photosensitivity.

Warnings and precautions before taking Acetazolamide :
Advise patient to discontinue Acetazolamide and contact health care provider immediately if any of the following occur: rash, hives, itching, sore throat, unexplained fever, pallor, purple spots under the skin, unusual bleeding or bruising, blood in urine, tingling or tremors in hands or feet, ringing in ears or hearing changes, flank or loin pain.
Advise patient that Acetazolamide drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
The safety and efficay of Acetazolamide medicine have not been studied in children and adolescents.
Advise patient that follow-up examinations and lab tests will be required to monitor Acetazolamide and to keep appointments.
Advise women to inform health care provider if pregnant, planning to become pregnant, or breastfeeding while taking Acetazolamide. Insulin is recommended to maintain blood glucose levels during

What if Overdose of Acetazolamide ?
If you think you or anyone else taken overdose of Acetazolamide , immediately telephone your doctor or contact your local or regional Poisons Information Centre Seek medical attention immediately. You may need urgent medical attention. Electrolyte imbalance, acidosis, CNS effects may be a sign of overdose of Acetazolamide.

What if Missed Dose of Acetazolamide ?
If you miss a dose of Acetazolamide medicine and you remember within an hour or so, take the dose immediately. If you do not remember until later, skip the dose you missed and go back to your regular schedule. Do not double doses.

Storage Conditions for Acetazolamide :
Dose is individualized depending on condition being treated.
Acetazolamide be used alone or in combination with other antiepileptic drugs (AEDs). Acetazolamide used as an adjunct to usual therapy when treating glaucoma. Store sustained-release capsules of Acetazolamide at controlled room temperature (68° to 77°F). Store tablets and powder for injection at ambient room temperature (59° to 86°F). Store Acetazolamide reconstituted injectable solution in refrigerator (36° to 46°F) for up to 3 days or use within 12 hr of reconstitution if stored at room temperature (59° to 86°F).

【原产地英文商品名】APO-ACETAZOLAMIDE TAB 250mg/tab 500tabs/bottle
【原产地英文药品名】ACETAZOLAMIDE
【中文参考商品译名】APO-乙酰唑胺片剂 250毫克/片 500片/瓶
【中文参考药品译名】乙酰唑胺
【中文参考化合物名称】N-(5-氨磺酰基-1,3,4-噻二唑-2-基) 乙酰胺
【生产厂家中文参考译名】APOTEX INC.
【生产厂家英文名】APOTEX INC.