Description of the medicine: Diacarbum (Diacarbum)
DIAKARB (Diacarbum). 2-Acetylamino-1, 3, 4-thiadiazole-5-sulfamide.
Synonyms: Acetazolamide, Fonurit, Acetazolamide, Acetazolamidum, Acetamox, Anicar, Dehydratin, Dilamox, Diluran, Diuramid, Ederen, Eumicton, Fonurit, Glaucomide, Glauconox, Glaupax, Lediidamid, Renidamox, Renidamid, others
White crystalline powder. Very slightly soluble in water and alcohol, easily in alkalis.
Diacarb is a representative of a group of drugs whose action is associated with the selective ability to inhibit the activity of carbonic anhydrase (carbonic anhydrase), an enzyme involved in the process of hydration and dehydration of carbonic acid. This property was first discovered in streptocide and other sulfonamide compounds, but in diacarb, whose molecule also contains a sulfonamide group, it is much more pronounced.
Diacarb can be used for therapeutic purposes in various conditions in which it is advisable to lower the activity of carbonic anhydrase. It has the greatest use as a diuretic, as well as for the treatment of glaucoma.
The diuretic effect is based on the inhibition of the activity of carbonic anhydrase in the kidneys and a change in the acid-base state (CBS) in the body. It acts mainly on the proximal tubules. Inhibition of carbonic anhydrase leads to a decrease in the formation of carbonic acid and a decrease in the reabsorption of bicarbonate and Na + tubule epithelium; urine excretion increases with Na +, HCO 3 -, and therefore, water excretion increases significantly; urine pH rises. Potassium ions are also released in large quantities under the influence of diacarb. An increase in chloride release does not occur. In connection with increased excretion of bicarbonates from the body, acidosis can develop. After stopping the use of diacarb, the alkaline reserve returns to the original after 1 - 2 days.
Diacarb is effective when taken orally. It is rapidly absorbed from the gastrointestinal tract and, entering the tissues and organs, inhibits the carbonic anhydrase contained in them.
Diacarb is used relatively rarely as a usual diuretic, since there are more effective drugs, but it is especially indicated for edema due to pulmonary heart disease, when it is advisable to lower the elevated levels of CO and bicarbonates in the blood.
Due to the decrease in CO in the blood, diacarb in some cases improves the condition of patients with pulmonary emphysema.
A pronounced diuretic effect is observed with the combined use of diacarb and aminophylline.
With ammonium chloride and other acid-forming diuretics, diacarb should not be combined, since the diuretic effect decreases or even completely disappears.
With edema of renal origin, diacarb is ineffective, and with cirrhosis, its use is undesirable because of the increased sensitivity of patients to hypokalemia, and also because of the danger of a possible increase in the content of ammonia in the blood.