Inhibitors, carbonic anhydrase

Z, ] McClarin, T Klein and R Langridge 1985. A Quantitative Structure-Activity Relationship and ecular Graphics Study of Carbonic Anhydrase Inhibitors. Molecular Pharmacology 27 493-498. 

Sulfonamides derived from sulfanilamide (p-arninoben2enesulfonainide) are commonly referred to as sulfa dmgs. Although several dmg classes are characterized by the presence of a sulfonamide function, eg, hypoglycemics, carbonic anhydrase inhibitors, saluretics, and tubular transport inhibitors, the antibacterial sulfonamides have become classified as the sulfa dmgs. Therapeutically active derivatives are usually substituted on the N nitrogen the position is generally unsubstituted. These features are illustrated by the stmctures of sulfanilamide (1) and sulfadiazine (2)... 

Thiadiazole-2-suifonamide, 5-acetamido-carbonic anhydrase inhibitor, 6, 576 crystal structure, 6, 548... 

Therapeutic Function Carbonic anhydrase inhibitor, diuretic, treatment of glaucoma Chemical Name N-[5-(aminosulfonyl)-1,3,4-thiadiazol-2-yl] acetamide Common Name —... 

Therapeutic Function Carbonic anhydrase inhibitor glaucoma treatment Chemical Name 48-Olchloro-m-benzenedisulfonamide Common Name DIclofenamid... 

Food containing salicylate (curry powder, paprika, licorice, prunes, raisins, and tea) may increase the risk of adverse reactions. Coadministration of the salicylates with activated charcoal decreases the absorption of the salicylates. Antacids may decrease the effects of the salicylates. Coadministration with the carbonic anhydrase inhibitors increases the risk of salicylism. Aspirin may increase the risk of bleeding during... 

Carbonic anhydrase is an enzyme that produces free hydrogen ions, which are then exchanged for sodium ions in the kidney tubules. Carbonic anhydrase inhibitors inhibit the action of the enzyme carbonic anhydrase This effect results in the excretion of sodium, potassium, bicarbonate, and water. Carbonic anhydrase inhibitors also decrease the production of aqueous humor in the eye, which in turn decreases intraocular pressure (IOP) (ie, the pressure within the eye). 

Adverse reactions associated with short-term therapy with carbonic anhydrase inhibitors are rare. Long-term use of these drug s may result in fever, rash, paresthesia... 

The carbonic anhydrase inhibitors are contraindicated in patients with known hypersensitivity to the dru , electrolyte imbalances, severe kidney or liver dysfunction, or anuria, and for long-term use in chronic non-congestive angle-closure glaucoma (may mask worsening glaucoma). 

If a carbonic anhydrase inhibitor is being given for absence or nonlocalized epileptic seizures, the nurse assesses the patient at frequent intervals for the occurrence of seizures, especially early in therapy and in patients known to experience seizures at frequent intervals. If a seizure does occur, the nurse records a description of the seizure in the patient s chart, including time of onset and duration. Accurate descriptions of the pattern and the number of seizures occurring each day helps the primary health care provider plan future therapy and adjust drug dosages as needed. 

Thiazide and related diuretics, loop diuretics, potassium-sparing diuretics, carbonic anhydrase inhibitors, triamterene Avoid exposure to sunlight or ultraviolet light (sunlamps, tanning beds) because exposure may cause exaggerated sunburn (photosensitivity reaction). Wear sunscreen and protective clothing until tolerance is determined. 

Carbonic anhydrase inhibitors During treatment for glaucoma, contact the primary health care provider immediately if eye pain is not relieved or if it increases. When a patient with epilepsy is being treated for seizures, a family member of the patient should keep a record of all seizures witnessed and bring this to the primary health care provider at die time of the next visit. Contact the primary healdi care provider immediately if die seizures increase in number. 

Viader MP, McKeever BM, Navia MA. Thienothiopyran-2-sulfonamides novel topically active carbonic anhydrase inhibitors for the treatment of glaucoma. J Med Chem 1989 32 2510-13. 

Complication of carbonic anhydrase inhibitor or topiramate pharmacotherapy... 

CAI, carbonic anhydrase inhibitor. (From LesarTS, Fiscella RG, Edward D. Glaucoma. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. 

Carbonic anhydrase inhibitors decrease aqueous humor production by inhibition of the carbonic anhydrase isoenzyme II located in the ciliary body. In the eye, carbonic anhydrase catalyzes the conversion of water and carbon dioxide to bicarbonate and hydrogen ion, which is a significant step in aqueous humor production. Carbonic anhydrase inhibitors are available in systemic and topical preparations.10,13,14... 

Local side effects include burning, stinging, itching, foreign body sensation, dry eyes, and conjunctivitis. Brinzolamide may have a lower incidence of these side effects since the drug is in a neutral pH solution. Dorzolamide has been reported to cause irreversible corneal decompensation. Taste abnormalities have been reported with each agent. Both topical carbonic anhydrase inhibitors are sulfonamides and are contraindicated in patients with history of sulfonamide hypersensitivity.10,13... 

The systemic carbonic anhydrase inhibitors are associated with significant adverse effects which include paresthesias of the hands and feet, nausea, vomiting, and weight loss. Patients... 

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