Medication Description: Diacarbum
DIAKARB (Diacarbum). 2-Acetylamino-1, 3, 4-thiadiazole-5-sulfamide.
Synonyms: Acetazolamide, Fonurit, Acetazolamide, Acetazolamidum, Acetamox, Ancerax, Acetamox, Degratin, Dilamox, Ehm, Emaicton, Glaucomide, Glauconox, Glauconax, Emeicton, Glauconide, Glauconox, Emeicton
White crystalline powder. Very little is soluble in water and alcohol, it is easy - in alkalis.
Diacarb is a member of a group of drugs whose action is related to 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 found in streptocide and other sulfanilamide compounds, but in diakarb, the molecule of which also contains a sulfonamide group, it is more pronounced.
Diacarb can be used for therapeutic purposes in various conditions in which it is advisable to reduce 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 carbonic anhydrase activity in the kidneys and the change in the acid-base state (CBS) in the body. It acts primarily 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; increased urinary Pa +, HCO 3 -, and therefore significantly increases the excretion of water; The urine pH rises. Potassium ions under the influence of diacarb are also released in greater quantities. Chloride emissions do not increase. Due to the increased release of bicarbonates from the body, acidosis can develop. After discontinuation of diakarb, the alkaline reserve returns to its 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.
As a common diuretic, diacarb is used relatively rarely, as there are more effective drugs, but it is especially indicated for edema due to pulmonary heart disease, when it is advisable to lower the high content of CO and bicarbonates in the blood.
In connection with a decrease in the CO content 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.
Diacarb should not be combined with ammonium chloride and other acid-forming diuretics, since the diuretic effect decreases or even disappears completely.
With edema of renal origin, diacarb is ineffective, and in case of liver cirrhosis, its use is undesirable because of the hypersensitivity of patients to hypokalemia, as well as the danger of a possible increase in the ammonia content in the blood.