DIACARBUM (Diacarbum; synonym: Fonurit, Fonuritum, Acetazolamide, Diamox, Diluran, Diuramid, Ederen, Nephramid etc.) — diuretic. 2-Ацетиламино-1,3,4-тиадиазол-5-сульфамид, C 4 H 6 N 4 S 2 O 3 :
White crystal powder, we will badly dissolve in water and alcohol, we will dissolve in alkalis.
Concerns to group of inhibitors karboangidraza (see). Under the influence of D. in cells of a renal epithelium formation of hydrogen ions which in usual conditions cosecrete in a gleam of tubules, obmenivdyas on ions of sodium decreases. The last unite in cells to anion coal to - you and reabsorbirutsya in blood in the form of bicarbonate, filling up an alkaline reserve of an organism. As a result the reabsorption of sodium decreases and release of bicarbonate with urine amplifies; the alkaline reserve of blood decreases, pH of urine accrues. A part of ions of sodium reabsorbirutsya at the same time in distal department of nephron, replacing potassium ions, excretion to-rogo amplifies. Therefore at prolonged use of D. it can be observed hypopotassemia (see).
Is quickly soaked up in went. - kish. a path, its action begins in 3 — 4 hours and 8 — 10 hour last. At a single dose, it is almost completely allocated with kidneys within the first days. Cumulation is not observed.
Drug apply hl. obr. at the hypostases connected with a circulatory unefficiency. Is effective also at nefroza and cirrhosis, however it is necessary to apply it with care as such patients are sensitive to a hypopotassemia. For the purpose of ensuring mutual compensation of changes of acid-base balance and strengthening of diuretic effect it is reasonable to combine drug with mercury diuretics since the last promote development of an alkalosis, and D. causes shift towards acidosis.
Apply also at glaucoma; its efficiency is connected with reduction of secretion of chamber moisture as a result of oppression of a karboangidraza of a ciliary body. Drug is especially effective at a bad attack of glaucoma. Sometimes D. use at treatment of epilepsy in a combination with anticonvulsants. The antiepileptic effect is connected, perhaps, with suppression of activity of a karboangidraza of a brain and reduction of formation of cerebrospinal liquid.
Drug is appointed inside on 0,25 — 0,5 g once a day within 2 — 3 days or every other day by 3 — 4 times with intervals between courses 3 — 5 days. At prolonged use it is necessary to appoint hydro-sodium carbonate and a potassium diet.
At D.'s glaucoma appoint 0,125 — 0,25 g to reception of 1 — 3 time a day, every 5 days do a break for 2 days. At epilepsy (small attacks) D. apply in 7 — 10 days of treatment by the main drug (Trimethinum); appoint 0,125 — 0,25 g to night, courses for 3 days with a break for the 4th day.
malotoksichen, is well transferred by patients, however in some cases it can cause drowsiness, disturbance of orientation, paresthesia, a loss of appetite.
it is contraindicated at acute diseases of a liver and kidneys, Addison's disease, tendency to acidosis.
Forms of release: powder and tablets on 0,25 g. Store in well corked container in the dry place.
See also Diuretics .
Bibliography: Jasinowski M. A., Terletsky T. M. and Rudenko N. B. Clinical use sulfanamide diuretic, Kiev, 1968, bibliogr.; The pharmacological basis of therapeutics, ed. by L. S. Goodman a. A. Gilman, L., 1975.
E. B. Berkhin.