Acetazolamide Health Dictionary

A drug that curbs the action of an ENZYME in the blood controlling the production of carbonic acid or bicarbonate from CARBON DIOXIDE (CO2). Called carbonic anhydrase, the enzyme is present in ERYTHROCYTES and it has a key part in maintaining the acid-base balance in the blood. Inhibiting drugs include ACETAZOLAMIDE and DORZOLAMIDE, and these are used as weak DIURETICS to reduce the increased intraocular pressure in ocular hypertension or open-angle GLAUCOMA (see EYE, DISORDERS OF).... carbonic anhydrase inhibitor

Linn.

Synonym: Vigna unquiculata (L.) Walp.

Family: Papilionaceae; Fabaceae.

Habitat: A pulse crop, particularly in Madras, Mysore, Mumbai and Hyderabad.

English: Horsegram.

Ayurvedic: Kulattha, Kulittha, Khalva, Vardhipatraka.

Unani: Kulthi.

Siddha/Tamil: Kollu, Kaanam.

Action: Plant—used in measles, smallpox, adenitis, burns, sores. Seeds—astringent, antipyretic, diuretic. Decoction or soup is used in affections of the liver and spleen, intestinal colic, in leucorrhoea and menstrual dissorders, urinary discharges. A valuable protein supplement.

The Ayurvedic Pharmacopoeia of India recommends the decoction of dry seeds in calculus and amenorrhoea.

The seeds contain crude protein 20.8, pentosan 10.8 and water-soluble gum 2.8%. The presence of antinu- tritional components such as haemag- glutinin and a protease inhibitor has been reported. The inhibitor activity decreased during germination.

The mean protein value of the seeds is 25.47% which is more or less equivalent to soybean, winged bean and gram. Nutritionally, the horsegram seeds are richer in lysine content when compared to Cajanus cajan (Arhar) pulse and gram pulse.

Presence of vitamin A in the green pods makes them a valuable diet for children; green leaves may be used in vitamin C deficiency syndrome, due to the presence of ascorbic acid and calcium. The seeds contain several common phytosterols.

Strepogenin—several times higher than in casein.

A decoction of seeds (soaked or boiled in water) is prescribed as diuretic and antilithiatic and has been clinically established.

Diuretic activity of a dipeptide (py- roglutamylglutamine) has been found to be 2-3 times that of acetazolamide in albino rats.

Globulin fraction of the seeds showed hypolipidaemic effects in rats.

A lectin-like glycoprotein from stems and leaves possesses carbohydrate- binding activity.

Dosage: Seed—6 g powder; decoction 50-100 ml. (CCRAS.)... dolichos biflorus

A group of disorders of the eye characterised by the intraocular pressure being so high as to damage the nerve ?bres in the retina and the optic nerve (see EYE) as it leaves the eye en route to the brain. The affected person suffers limitation of the ?eld of vision and on examination the optic disc can be seen to be cupped. The clinical signs depend on the rate and extent of rise in pressure.

Individuals most at risk have a family history of GLAUCOMA (especially among siblings), are myopic (short-sighted), or have diabetic or thyroid eye disease. People with a strong family history of the disease should have regular eye checks, including tonometry, from the age of 35 years.

Glaucoma is usually classi?ed as being either open-angle glaucoma or narrow-angle glaucoma.

Open-angle glaucoma is a chronic, slowly progressive, usually bilateral disorder. It occurs in one in 200 of people over 40 and accounts for 20 per cent of those registered blind in Great Britain. Symptoms are virtually non-existent until well into the disease, when the patient may experience visual problems. It is not painful. The characteristic ?ndings are that the intraocular pressure is raised (normal pressure is up to 21 mm Hg) causing cupping of the optic disc and a glaucomatous visual-?eld loss. The angle between the iris and the cornea remains open. Treatment is aimed at decreasing the intraocular pressure initially by drops, tablets and intravenous drug administration. Surgery may be required later. A trabeculectomy is an operation to create a channel through which ?uid can drain from the eye in a controlled fashion in order to bring the pressure down.

Narrow-angle glaucoma affects one in 1,000 people over 40 years of age and is more common in women. Symptoms may start with coloured haloes around street lights at night. These may then be followed by rapid onset of severe pain in and around the eye accompanied by a rapid fall in vision. One eye is usually affected ?rst; this alerts the surgeon so that action can be taken to prevent a similar attack in the other eye. Treatment must be started as an emergency with a topical beta blocker (see BETA-ADRENOCEPTOR-BLOCKING DRUGS) in eye drops with other drugs such as ADRENALINE or pilocarpine added as necessary. Dorzolamide, a topical anhydrase inhibitor, can also be used. ACETAZOLAMIDE, also an anhydrase inhibitor, can be given by mouth. In an emergency before surgery, MANNITOL can be given through an intravenous infusion; this is followed by surgery to prevent recurrence. Acute narrow-angle glaucoma occurs because the peripheral iris is pushed against the back of the cornea. This closes o? the angle between iris and cornea through which aqueous humour drains out of the eye. Since the aqueous humour cannot drain away, it builds up inside the eye causing a rapid increase in pressure.

Various types of LASER treatment – trabeculoplasty (‘burning’ the trabecular network); iridotomy (cutting holes to relieve pressure); and ciliary-body ablation by ‘burning’ – are sometimes used in preference to surgery.... glaucoma