Talk:Acetazolamide/Archive 1

Archive 1

disclaimer

Note that the medical disclaimer was originally added before the "Disclaimers" link appeared as part of the standard page header. RedWolf 03:59, Feb 24, 2004 (UTC)

Could somebody please add information about Acetazolamide's use in the treatment of Hypokalemic periodic paralysis? My wife suffered from HPP for over 30 years and when she began treatment using Acetazolamide her episodes have decreased from three to four per week to maybe once per year. HPP and it's associated conditions are exceedingly rare at about one per hundred thousand people.

Acetazolamide for migraine-associated vertigo

Would like someone to add research on how otolaryngologists (ENTs) are using Diamox to treat migraine-associated vertigo. These attacks or episodes are severe and debilitating. I'm being treated via Diamox. Would like a medical specialist to add his/her findings to this page. SedonaSue 00:57, 21 July 2007 (UTC)

Quick search at PubMed shows up, some interesting stuff. But not yet fully proven, nor commonly accepted into routine clinical practice and probably comes under research off-license usage (although I'm glad you found it helpful):

• Ambrosini A, Pierelli F, Schoenen J (2003). "Acetazolamide acts on neuromuscular transmission abnormalities found in some migraineurs". Cephalalgia : an international journal of headache. 23 (2): 75–8. PMID 12603362.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• De Simone R, Marano E, Di Stasio E, Bonuso S, Fiorillo C, Bonavita V (2005). "Acetazolamide efficacy and tolerability in migraine with aura: a pilot study". Headache. 45 (4): 385–6. doi:10.1111/j.1526-4610.2005.05077_3.x. PMID 15836579.{{cite journal}}: CS1 maint: multiple names: authors list (link)

As a secondary source review:

• Black DF (2006). "Sporadic and familial hemiplegic migraine: diagnosis and treatment". Seminars in neurology. 26 (2): 208–16. doi:10.1055/s-2006-939921. PMID 16628531. - which concludes "Thus far, treatment trials are anecdotal, although verapamil and acetazolamide have shown promise"

Somewhat different findings are:

• Sakashita Y, Kanai M, Sugimoto T, Taki S, Takamori M (1997). "Changes in cerebral blood flow and vasoreactivity in response to acetazolamide in patients with transient global amnesia". J. Neurol. Neurosurg. Psychiatr. 63 (5): 605–10. PMID 9408101.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Warner JS, Wamil AW, McLean MJ (1994). "Acetazolamide for the treatment of chronic paroxysmal hemicrania". Headache. 34 (10): 597–9. PMID 7843957.{{cite journal}}: CS1 maint: multiple names: authors list (link)

David Ruben ^Talk 02:50, 21 July 2007 (UTC)

David Ruben, thank you for the links. I wish to remain anonymous for now, however, 3 months after my first post, the Diamox seems to be working for me. In either 2002 or 2003, I began having about 3 episodes a year of debilitating vertigo. I rarely have headaches and "never" had migraines. When the otolaryngologist told me I had "silent", or common, migraines causing the vertigo, I was honestly shocked. Then, I remembered that a year ago I experienced one aura with a migraine headache. The vertigo began in my mid-40s, so I suspect my "silent" migraines and resulting vertigo may be caused by my (now) fluctuating hormones. Plus, now I am more sensitive to barometric changes.

A woman I know in her 30s was also on Diamox for vertigo, and she has experienced success as well. She's encouraged me to stay on my doctor's program of taking Diamox for six months. Then, he will wean me off of it. She no longer needs to be on acetazolamide. She saw four different physicians, who said "it was all in her head". Doctor #5 told her, "well, they were right in a way...it is in your head...migraines."

I want to learn more about the effects of calcium and potassium levels, plus an acidic pH environment versus a base/alkaline.

If the Diamox therapy works for me like it did for my colleague, I'll be thrilled and the side effects will be worth it. I now drink a glass of lemonade daily to prevent kidney stones (recommended by my husband's urologist), and I now eat one banana each morning for potassium. However, I now bruise very easily, and the bruises take twice as long to heal. I've gotten used to the tingling and it happens only sporadically, and usually right after I have taken one of the 2x per diem 125 mg doses. My doctor wanted to gradually increase the dosages to 500mg/per diem, but agreed to keep me at 250mg as long as it worked. It's better than waking up one morning with the entire universe spinning rapidly around you, and all you can do is close your eyes and stay in bed, not daring to move your head, so you can try to "sleep" away the first 24 hours. (Meclizine can only do so much.) Then, deal with one or more weeks of constant, low-grade dizziness.

That's why I hope others post more links or comments related to acetazolamide studies and migraine-associated vertigo. I apologize this is so long, but together maybe we all could help other people get their lives back.SedonaSue 06:35, 23 September 2007 (UTC)

Carbonic Anhydrase Action Wrong

This page states that carbonic anhydrase produces H+ and HCO3-. It does not, it should be placed that:

1. CO2 + H2O <--> H2CO3

2. H2CO3 <--> H+ + HCO3-.

The 2nd Part of this reaction reaches equilibrium almost instantaneously, however the FIRST part is catalysed by carbonic anhydrase.

That is my understanding, too.....why don't you fix it. D.I.L. (talk) 21:51, 23 February 2009 (UTC).

Mechanism for reduced CO₂/alkalosis

I am not an expert in altitude sickness, I'm not sure that Neeral's explanation of how blood CO₂ is reduced is correct. I believe that the major cause of alkalosis is not related to the decreased solubility of CO₂, but rather the hypoxia-driven increased ventilation (respiratory alkalosis). Is there any literature support for this assertion? D.I.L. (talk) 14:34, 12 March 2009 (UTC).

Thank you Danielil for clarifying that issue. I am not an expert by far on altitude sickness, and I apologize for confusion that I may have caused readers, and as such I have removed my contribution until I can straighten it out. I understand that the primary cause of alkalosis is the hypoxia-driven ventilation. I meant to suggest the CO₂ out-gassing method for alkalosis as a minor contributing factor. I will actually research into this further and if necessary re-state the intended information to make logical sense. I was reading the following article and ended up posting incorrect assertations. (David E. Leaf and David S. Goldfarb, Mechanisms of action of acetazolamide in the prophylaxis and treatment of acute mountain sickness, pmid=17023566 doi=10.1152) - neeral - (talk) 08:32, 16 March 2009 (UTC)

I think Danielil is right, and that the current explanation is close but doesn't address the primary problem with altitude inducing a ventilation-induced alkalosis. I would correct but I am without literature access to double check. My understanding is although the acidosis will certainly increase respiratory drive (usually the chief stimulus for respiratory drive at sea level), high altitudes with a low paO2, paO2 will be a significant factor in respiratory drive (as pA02 can reach ~40mmHg @ 18,000ft), leading to hypoxemia-induced respiratory alkalosis from increased ventilation. Basically, you breathe to get the oxygen, but too much ventilation and give off too much CO2, and get alkalotic, which, along with hypoexmia makes you feel sick. So, this is why it is advantageous to prep by inducing a metabolic acidosis, and you can still breathe more, getting more oxygen, and remain at a physiologic pH. Apologies for the jargon and run-on sentences, I hope that helps. thanks 166.191.190.187 (talk) 16:51, 26 May 2010 (UTC)