乙酰唑胺片的作用功效及副作用？

Belongs to the first generation of oral carbonic anhydrase inhibitors. It can inhibit the activity of carbonic anhydrase in the body, reduce the production of bicarbonate, thereby reducing the formation of aqueous humor, reducing intraocular pressure and intracranial pressure, improving pulmonary and cerebral edema, increasing arterial oxygen tension and other clinical effects. Common side effects of this drug include headache, discomfort, fatigue, fever, pain at the injection site, flushing, growth retardation in children, flaccid paralysis, allergic reactions, etc.

About Acetazolamide Tablets

Acetazolamide is a sulfonamide carbonic anhydrase inhibitor. Its main mechanism of action is to inhibit the activity of carbonic anhydrase in renal tubular epithelial cells, ciliary epithelial cells, pancreatic cells and central nervous cells, thereby producing diuresis, lowering intraocular pressure and improving metabolism. It is mainly used in clinical treatment of glaucoma, cardiogenic edema and cerebral edema. In recent years, it has also been used for the preventive treatment of tumors, cerebrovascular diseases and metabolic bone diseases in mountain sickness.

The role of acetazolamide tablets

Acetazolamide tablets are a carbonic anhydrase inhibitor that inhibits carbonic anhydrase in renal tubular epithelial cells and reduces the reabsorption of HCO3-, thereby causing metabolic acidosis in the body. The H+ concentration in the body increases, stimulating the excitement of the respiratory center, increasing pulmonary ventilation, thereby increasing oxygen partial pressure and oxygen saturation, and reducing carbon dioxide partial pressure.

Recent research shows that acetazolamide tablets also have other effects, including:

1. Reduce the volume of red blood cells: Acetazolamide tablets can reduce the volume of red blood cells and may affect the morphology and function of red blood cells through some mechanisms.

2. Reduce serum erythropoietin (EPO): Acetazolamide tablets may reduce the amount of EPO released by the kidneys, thereby reducing the concentration of EPO in the serum.

3. Reduce serum transferrin: Acetazolamide tablets may reduce the synthesis and release of transferrin, thereby reducing the concentration of transferrin in the serum.

4. Increase oxygen partial pressure and serum ferritin concentration: Acetazolamide tablets can increase oxygen partial pressure and serum ferritin concentration by regulating the mechanism of respiration and oxygenation.

5. Increase ventilation and improve sleep apnea: Acetazolamide tablets can increase lung ventilation and improve the symptoms of sleep apnea.

6. Increase arterial blood oxygen saturation: Acetazolamide tablets can increase the oxygen saturation in arterial blood.

Therefore, acetazolamide tablets may have certain efficacy in the treatment of chronic altitude sickness. However, the specific dosage and course of treatment should be based on the doctor's advice and prescription, and used under the supervision of a doctor.

Efficacy of Acetazolamide Tablets

A double-blind, randomized, controlled non-inferiority trial in 2020 verified the efficacy of acetazolamide tablets at a lower dose (125mg/d) and the recommended dose (250mg/d) in preventing acute mountain sickness (AMS). Comparing 62.5 mg acetazolamide tablets twice daily with the recommended dose of 125 mg acetazolamide tablets twice daily from an altitude of 1240m to 3810m, the primary outcome measures were the incidence of AMS, Lake Louise Questionnaire ≥3, and other symptoms. The results confirmed that the efficacy of acetazolamide tablets 125 mg/d in preventing AMS was not equivalent to that of 250 mg/d. Due to the increased incidence of AMS and the lack of significant symptom improvement, Acetazolamide Tablets 125 mg/d are not recommended for the prevention of AMS.

Side effects of acetazolamide tablets

In experiments, it was found that the systemic side effects of acetazolamide tablets are: headache, discomfort, fatigue, fever, pain at the injection site, flushing, growth retardation in children, flaccid paralysis, and allergic reactions. The following are some measures to deal with the possible side effects of acetazolamide tablets:

1. Headache: If you have a headache, you can try rest, relaxation and light exercise. Avoid overuse of pain relief medications unless directed by your doctor. If the headache persists or worsens, it is recommended to seek medical advice.

2. Discomfort and fatigue: If discomfort and fatigue occur, rest and adjust the intensity of daily activities. Get enough rest and sleep, and maintain a good diet and fluid intake. If discomfort and fatigue persist or worsen, it is recommended to seek medical advice.

3. Fever: If fever occurs, you can take antipyretic drugs, such as acetaminophen, and use them according to the instructions of your doctor or pharmacist. If the fever lasts for more than a few days or is accompanied by other severe symptoms, it is recommended to seek medical advice as soon as possible.

4. Pain at the injection site: If there is pain at the injection site, you can apply cold or hot compresses after the injection to relieve discomfort. If the pain persists or worsens, or if redness, swelling, oozing and other abnormalities occur, it is recommended to seek medical advice.

5. Flushing: If flushing occurs, you can avoid exposure to high temperatures or humidity and keep your body cool and comfortable. If flushing persists or worsens, it is recommended to seek medical advice.

6. Growth retardation in children: If children taking acetazolamide tablets experience growth retardation, it is recommended to consult a pediatrician in time. The doctor may evaluate your child and decide if the dose of medication needs to be adjusted or other measures taken.

7. Flaccid paralysis: If symptoms of flaccid paralysis occur, you should stop using Acetazolamide tablets immediately and seek emergency medical treatment. Flaccid paralysis can be a serious side effect and requires urgent attention from a medical professional.

8. Allergic reaction: If allergic reaction occurs, such as rash, itching, difficulty breathing, etc., you should stop using Acetazolamide tablets immediately and seek medical emergency treatment.

Please note that the above solutions are only general suggestions. If you experience any side effects or discomfort, it is recommended to seek prompt advice from your doctor or pharmacist. They can provide you with individualized guidance and treatment recommendations.

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