Complex treatment of hypertension includes combinations of different groups of drugs with diuretics. "Diacarb" is one of the most used drugs in clinical practice, which belongs to the class of carbonic anhydrase inhibitors with a moderate effect. The drug is widely prescribed by neurologists, cardiologists and ophthalmologists. Accelerated excretion of potassium ions from the blood is one of the undesirable consequences of taking the drug. Replenishment of electrolyte reserves is carried out with the help of anionic-cationic preparations, to which "Asparkam" belongs.
What are the indications for the use of "Asparkam" together with "Diakarb"?
Acetazolamide (active ingredient "Diacarba") - a derivative of sulfanilic acid, which blocks carbonic anhydrase, reducing the synthesis of sulfur dioxide and water. Pharmacodynamic effects of the drug:
- Improving renal blood flow - increases diuresis (diuretic effect) and removes potassium from the body (used to correct moderate hyperkalemia).
- Regulation of fluid production by the ciliary body - reduces intraocular pressure in glaucoma.
- A decrease in the reabsorption of hydrocarbons in the tubules of the nephron leads to the development of transient (transient) acidosis. The condition returns to normal within 1-2 days after the drug is discontinued.
- The accumulation of carbon dioxide in the tissues of the brain - reduces the excitability of neurons, prevents the development of pathological impulses. The effect is used to prevent epileptic seizures.
- Controlling the synthesis of cerebrospinal fluid in the ventricles of the brain - normalizes the level of intracranial pressure in intracranial hypertension.
Indications for the use of "Diakarba" in different areas are presented in the table.
| Clinic | Pathology |
|---|---|
| Ophthalmic |
|
| Therapeutic |
|
| Neurological |
|
Features of the metabolism of the drug "Diacarba":
- absorbed in the cavity of the small intestine;
- the degree of binding to blood proteins is 70-90%;
- “Target structures”, the tissues of which are rich in the enzyme carbonic anhydrase: kidneys, eyeball, erythrocytes, central nervous system;
- excretion in the urine, unchanged;
- 90% of the active substance is eliminated within 24 hours.
The undesirable consequences of taking the drug are most often encountered at the first stage of therapy (2-3 weeks). The main groups of side effects are presented in the table.
| Category | Symptoms |
|---|---|
| |
| From the digestive tract |
|
| Neurological |
|
| Ophthalmic |
|
| From the genital organs |
|
| Excretory system |
|
The mechanism of development of most of the side effects is associated with impaired potassium metabolism in the body. One way to prevent symptoms is to take electrolyte donors. For example, use the scheme - "Asparkam" with "Diakarb".
Composition of "Asparkam" - aspartate salts of potassium (K +) and magnesium (Mg2 +). The medicine is intended for the regulation of metabolic processes, mainly in the myocardium. Asparaginate transports ions inside the cell, where they are involved in the process of muscle contraction at the molecular level. The drug is prescribed for the correction of electrolyte disturbances (deficiency of potassium and magnesium in the body), for the prevention of hypokalemia in the treatment of loop diuretics.
Contraindications to the appointment of "Asparkam":
- renal failure;
- hemolytic anemia;
- hyperkalemia;
- myasthenia gravis;
- violation of AV conduction.
In patients with antacid gastritis, dyspeptic symptoms, burning in the epigastrium, nausea, and diarrhea are observed.
Admission regimens for adults
The use of the "Diakarba" complex with "Asparkam" implies compliance with the recommendations:
- absorption of a diuretic does not depend on food intake, therefore it is taken at any time of the day.
- a stable effect is observed when using a therapeutic dose once a day, or every other day.
The scheme of taking "Diakarba" and "Asparkam" by adults for various diseases is presented in the table.
| Pathology | "Diakarb" | "Asparkam" |
|---|---|---|
| Edematous syndrome of cardiovascular genesis | 250 mg (1 tablet) per day | 1 tablet 3 times a day (under the control of blood osmolarity 310-320 mosm / l) |
| Open angle glaucoma | 250 mg 3-4 times a day | |
| Epilepsy | 8-30 mg / kg body weight / day (divided into 4 doses). The maximum daily dose is 1000 mg (4 tablets) | |
| Altitude sickness (to speed up acclimatization) | 500 mg 2 times a day. Prevention of symptoms - 2 days before the rise | |
| Headache (after traumatic brain injury) | 250 mg 2-3 times a day | |
| Periodic paralysis | 250 mg 4 times a day |
In cardiological practice, "Diacarb" is not prescribed together with Acetylsalicylic acid ("Aspecard", "Aspirin") because of the high risk of severe acidosis, lethargy, coma, and death.
Use in childhood
In pediatric practice, "Diacarb" is prescribed for the treatment of neurological diseases:
- hydrocephalus - the accumulation of fluid due to increased synthesis of cerebrospinal fluid or impaired outflow;
- epilepsy with "small" seizures: partial (Jacksonian), myoclonus and absences.
The most sensitive to the drug are CSF dynamics disorders, which are accompanied by interstitial cerebral edema. This type of intracranial hypertension is caused by an increased content of Na + and water ions in the periventricular (periventricular) white matter.
Clinical signs of pathology:
- Headache. Complaints of children about the feeling of "bloating", "squeezing the eyes." Aggravated by tilting the head and coughing. The pain is most pronounced in the morning, immediately after waking up.
- Vomiting, after which the intensity of the symptom decreases.
- Stagnation in the fundus is a pathognomonic (most specific) symptom.
Conservative treatment of pathology implies:
- diet with limited salt intake;
- drinking regimen (reducing the amount of fluid consumed);
- taking diuretics ("Diacarba"), glucocorticoids (in severe cases).
Surgical treatment is indicated if drug therapy is ineffective for 2 months. "Diacarb" for epilepsy in children is an auxiliary element for basic anticonvulsants.
Neurologists prescribe a combination of Diacarba and Asparkam once before routine vaccination (DPT, PDA, Imovax-Polio) in order to prevent complications in children at risk. Taking medications does not reduce the likelihood of developing a convulsive syndrome.
Parents' complaints about prolonged crying, sleep disturbances, increased excitability are not indications for taking the drug. To reduce nervous excitement in pediatric practice, use "Cinnarizine" or "Glycine".
How to take "Asparkam" and "Diakarb" for children correctly?
Prescription of drugs in pediatric practice is carried out taking into account the child's body weight. Doses and recommendations on how to take Asparkam with Diakarb are presented in the table.
| Pathology | Dosage calculation | special instructions |
|---|---|---|
| Hydrocephalus |
| Take in the morning, once |
| Epileptic seizures |
|
|
Correction of the dose and regimen of the use of anticonvulsants is carried out 2 times a year.
Long-term diuretic therapy requires periodic monitoring of blood pH, water and electrolyte balance. It is recommended to take "Asparkam" with "Diakarb" in case of laboratory confirmed hypokalemia and hypomagnesemia.
Conclusions
"Diacarb" is a drug that has a moderate diuretic effect, gradually decreasing with prolonged use. The medication is prescribed as part of the complex therapy of neurological and cardiovascular disorders.
In order to prevent water-electrolyte imbalance, it is recommended to use regimens that include Asparkam. The selection of the effective dose, regimen and duration of the course of therapy is carried out by the attending physician. Before you start, you should read the instructions.
