Acetazolamide

Acetazolamide is a medication that belongs to the class of carbonic anhydrase inhibitors. It is

used to treat a variety of medical conditions such as glaucoma, epilepsy, altitude sickness, and
edema.

Therapeutic Category: Acetazolamide is classified as a diuretic and a carbonic anhydrase

inhibitor.

Available Dose and Dosage Form: Acetazolamide is available in tablet form, with strengths
ranging from 125mg to 500mg.

Relation with Food: Acetazolamide should be taken with food or milk to reduce stomach upset.

Mechanism of Action: Acetazolamide works by blocking the enzyme carbonic anhydrase, which
is responsible for the production of bicarbonate in the body. This leads to an increase in the
excretion of bicarbonate and sodium, resulting in the diuretic effect of the drug.

Indications and Dose:

 Glaucoma: The usual dose is 250mg to 1g per day, in divided doses.

 Epilepsy: The usual dose is 8 to 30mg/kg per day, in divided doses.
 Altitude sickness: The usual dose is 125mg to 1g per day, in divided doses.
 Edema: The usual dose is 250mg to 375mg per day, in divided doses.

Adverse Drug Reactions: The most common adverse reactions include nausea, vomiting,
diarrhea, loss of appetite, and tingling sensations. Other side effects may include drowsiness,
confusion, dizziness, headaches, and a decrease in potassium levels.

Contraindications: Acetazolamide is contraindicated in patients who are allergic to the drug or

to sulfa drugs. It should also not be used in patients with liver or kidney disease, severe
respiratory acidosis, or in patients with a low blood pH.

Precautions and Warnings: Acetazolamide should be used with caution in patients with a
history of kidney stones or gout, as the drug may increase the risk of developing these
conditions. The drug should also be used with caution in patients with a history of metabolic
acidosis or electrolyte imbalances. It is important to monitor electrolyte levels and kidney
function in patients taking acetazolamide. Finally, the drug should not be used during
pregnancy or while breastfeeding.
 Mannitol

Therapeutic Category: Mannitol is classified as an osmotic diuretic.

Trade Names: Mannitol is available under various trade names such as Osmitrol, Resectisol,
Aridol, Mannitol IV, and many others.

Available Dose and Dosage Form: Mannitol is available as a sterile solution for injection or
infusion. The concentration of mannitol in the solution ranges from 5% to 25%.

Relation with Food: There are no specific food interactions associated with mannitol. However,
it is important to maintain adequate hydration during treatment with mannitol to prevent
dehydration.

Mechanism of Action: Mannitol works by increasing the osmotic pressure of the blood and the
extracellular fluid, which reduces the reabsorption of water and electrolytes in the kidneys. This
results in an increase in urine output and a decrease in edema.

Indications and Dose:

 Cerebral edema: The usual dose is 0.25 to 1g/kg body weight, administered as an intravenous
infusion over 30 to 60 minutes.
 Acute renal failure: The usual dose is 20% solution at a dose of 0.25 to 2g/kg body weight,
administered as an intravenous infusion over 30 to 60 minutes.
 Intraocular pressure: The usual dose is 1.5 to 2g/kg body weight, administered as an
intravenous infusion over 30 to 60 minutes.
 Diagnostic aid: Mannitol is also used as a diagnostic aid in certain procedures such as computed
tomography (CT) scans and magnetic resonance imaging (MRI) scans.

Adverse Drug Reactions: The most common adverse reactions associated with mannitol include
fluid and electrolyte imbalances, dehydration, hypotension, headache, nausea, vomiting, and
dizziness. Rarely, mannitol can cause an allergic reaction, which may manifest as skin rash,
hives, and difficulty breathing.

Contraindications: Mannitol is contraindicated in patients who are allergic to the drug or have
severe dehydration, congestive heart failure, or pulmonary congestion. It should also not be
used in patients with active intracranial bleeding, severe kidney disease, or severe electrolyte
imbalances.

Precautions and Warnings: Mannitol should be used with caution in patients with a history of
heart or kidney disease, as it can worsen these conditions. It is also important to monitor fluid
and electrolyte balance in patients receiving mannitol, especially in those with pre-existing
 imbalances. Finally, mannitol should not be used during pregnancy or while breastfeeding
unless the potential benefits outweigh the potential risks.

Nifedipine

Therapeutic Category: Nifedipine is classified as a calcium channel blocker.

Trade Names: Nifedipine is available under various trade names such as Procardia, Adalat,
Nifedical, Afeditab, and others.

Available Dose and Dosage Form: Nifedipine is available as immediate-release tablets,

extended-release tablets, and capsules with strengths ranging from 10mg to 90mg.

Relation with Food: Nifedipine should be taken on an empty stomach, as food can decrease the
absorption of the drug. It is recommended to avoid grapefruit or grapefruit juice while taking
nifedipine, as it can increase the risk of side effects.

Mechanism of Action: Nifedipine works by blocking the entry of calcium ions into the smooth
muscle cells of blood vessels and the heart. This results in relaxation of the blood vessels,
leading to a decrease in blood pressure and an increase in blood flow to the heart.

Indications and Dose:

 Hypertension: The usual starting dose is 30mg once daily, which may be increased to a
maximum of 90mg once daily.
 Angina: The usual starting dose is 10mg to 20mg three times daily, which may be increased to a
maximum of 120mg per day.
 Raynaud's syndrome: The usual starting dose is 30mg once daily, which may be increased to a
maximum of 90mg once daily.

Adverse Drug Reactions: The most common adverse reactions associated with nifedipine
include headache, dizziness, flushing, nausea, constipation, and peripheral edema. Other side
effects may include low blood pressure, palpitations, and allergic reactions.

Contraindications: Nifedipine is contraindicated in patients with a known hypersensitivity to the

drug, severe hypotension, or unstable angina. It should also not be used in patients with
cardiogenic shock or aortic stenosis.

Precautions and Warnings: Nifedipine should be used with caution in patients with liver or
kidney disease, as the drug is metabolized in the liver and excreted by the kidneys. It is also
important to monitor blood pressure and heart rate in patients receiving nifedipine, especially
 in those with pre-existing cardiovascular disease. Finally, nifedipine should not be used during
pregnancy or while breastfeeding unless the potential benefits outweigh the potential risks

Amlodipine

Therapeutic Category: Amlodipine is classified as a calcium channel blocker.

Available Dose and Dosage Form: Amlodipine is available as immediate-release tablets and
capsules with strengths ranging from 2.5mg to 10mg.

Relation with Food: Amlodipine can be taken with or without food, but it is recommended to
avoid grapefruit or grapefruit juice while taking amlodipine, as it can increase the risk of side
effects.

Mechanism of Action: Amlodipine works by blocking the entry of calcium ions into the smooth
muscle cells of blood vessels and the heart. This results in relaxation of the blood vessels,
leading to a decrease in blood pressure and an increase in blood flow to the heart.

Indications and Dose:

 Hypertension: The usual starting dose is 5mg once daily, which may be increased to a maximum
of 10mg once daily.
 Angina: The usual starting dose is 5mg to 10mg once daily, which may be increased to a
maximum of 10mg once daily.

Adverse Drug Reactions: The most common adverse reactions associated with amlodipine
include headache, dizziness, flushing, edema, and fatigue. Other side effects may include low
blood pressure, palpitations, and allergic reactions.

Contraindications: Amlodipine is contraindicated in patients with a known hypersensitivity to

the drug, severe hypotension, or unstable angina. It should also not be used in patients with
cardiogenic shock or aortic stenosis.

Precautions and Warnings: Amlodipine should be used with caution in patients with liver or
kidney disease, as the drug is metabolized in the liver and excreted by the kidneys. It is also
important to monitor blood pressure and heart rate in patients receiving amlodipine, especially
in those with pre-existing cardiovascular disease. Finally, amlodipine should not be used during
pregnancy or while breastfeeding unless the potential benefits outweigh the potential risks.