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Acetazolamide is a first generation carbonic anhydrase inhibitor and it decreases the ocular fluid and osmolality in the eye to decrease intraocular pressure. [5] [6] Common side effects include numbness, ringing in the ears, loss of appetite, vomiting, and sleepiness. [2]
The drug acetazolamide (trade name Diamox) may help some people making a rapid ascent to sleeping altitude above 2,700 metres (9,000 ft), and it may also be effective if started early in the course of AMS. [20] Acetazolamide can be taken before symptoms appear as a preventive measure at a dose of 125 mg twice daily.
Dorzolamide, developed by Merck, was the first medication in human therapy (market introduction 1995) that resulted from structure-based drug design. It was developed to circumvent the systemic side effects of acetazolamide which has to be taken orally.
For venous insufficiency, the dosage is 2 tablets of 500mg daily. For acute hemorrhoidal attack, the dosage is 6 tablets daily for 4 days, followed by 4 tablets daily over the next 3 days. [15] For chronic venous disease, the dosage is 2 tablets a day for at least 2 months. [16]
Serious side effects include hypothyroidism, diabetes insipidus, and lithium toxicity. [5] Blood level monitoring is recommended to decrease the risk of potential toxicity. [ 5 ] If levels become too high, diarrhea, vomiting, poor coordination, sleepiness, and ringing in the ears may occur. [ 5 ]
Topiramate selectively inhibits cytosolic (type II) and membrane-associated (type IV) forms of carbonic anhydrase. Its action on carbonic anhydrase isoenzymes may contribute to the drug's side effects, including its propensity to cause metabolic acidosis and calcium phosphate kidney stones.
While definitive sites of metabolism have not been firmly established, there are several metabolites worthy of note. N-Desethylbrinzolamide is an active metabolite of the parent compound, and thus exhibits carbonic anhydrase inhibitory activity (largely carbonic anhydrase-I, when in the presence of Brinzolamide) and also accumulates in the erythrocytes.
In the intention-to-treat analysis, people treated with CagriSema lost 20.4% of their body weight over 68 weeks, versus 11.5% with cagrilintide 2.4 mg alone, 14.9% with semaglutide 2.4 mg alone, and 3.0% with placebo.