Carbonic anhydrase inhibitors
Acetozolamide
Dose: To be used up to 4 tablets per day.
Side effects: Use of oral acetazolamide is associated with tingling, numbness, altered taste, indigestion, nausea, vomiting, skin rashes. Take food rich in potassium (orange juice, bananas, coconut water) to reduce side effects. In some cases, potassium supplement tablets may be prescribed.
Contra-indicated: Not to be used in patients with sickle cell disease (particularly for oral medication). Not to be used/or used with caution in patients with poor renal function, or history of renal lithiasis (renal calculi) or gallbladder lithiasis (gallstones). As patients with sulfa allergy may get allergy from carbonic anhydrase inhibitors, please discuss this with your ophthalmologist.
Hyperosmotic agents
Mannitol
Dose: usually to be a one time use for acute angle closure attack and other specific conditions for in hospital use.
Side effect: Use intravenous mannitol may pull water from the tissues into the vessels, and may cause many systemic side effects, such as dehydration headache, nausea, diarrhea, vomiting, dry mouth, thirst, blurred vision, vomiting, runny nose, arm pain, chills, dizziness, low blood pressure (hypotension), hives, irregular heart beat, electrolyte imbalance, etc.
Contra-indicated: Not to be used in patients with poor renal function, or poor cardiac function (congestive heart failure), and other specific systemic conditions.
Glycerol: also may be used for acute angle closure. Glycerol is an oral solution, and as mannitol, may also cause many systemic side effects. Particularly, this medication should be avoided by patients with Diabetes.
