Abstract THE FOLLOWING study on the treatment of glaucoma with the carbonic anhydrase inhibitor acetazoleamide ( 2-acetylamino-1,3,4-thiadiazole-5-sulfonamide; Diamox) was initiated in October, 1953, and covers a four-month period of observation. Inhibition of carbonic anhydrase by acetazoleamide is a new and useful means of lowering the intraocular pressure. Acetazoleamide, a heterocyclic sulfonamide, was developed by Roblin and associates, in 1950,* as a diuretic agent whose action was based on inhibition of carbonic anhydrase in the renal tubular epithelium. Carbonic anhydrase catalyzes the hydration of carbon dioxide to form carbonic acid: H2O+CO2⇄ H2CO3. The carbonic acid dissociates to form H+ and HCO3-. Thus, the level of hydrogen ions and bicarbonate ions is affected by this enzyme. In the kidney there ensues a hydrogen-sodium exchange between the tubular epithelium and the glomerular filtrate, resulting in the normal conservation of base and the formation of an acid urine. References 1. References 1 and 2. 2. Maren, T. H.: Personal communication to the authors. 3. Roblin, R. O., Jr., and Clapp, J. W.: Preparation of Heterocyclic Sulfonamides , J. Am. Chem. Soc. 72:4890, 1950.Crossref 4. Miller, W. H.; Dessert, A. M., and Roblin, R. O., Jr.: Heterocyclic Sulfonamides as Carbonic Anhydrase Inhibitors , J. Am. Chem. Soc. 72:4893, 1950.Crossref 5. Pitts, R. F., and Alexander, R. S.: Nature of the Renal Tubular Mechanism for Acidifying the Urine , Am. J. Physiol. 144:239, 1945. 6. Maren, T. H.: Pharmacological and Renal Effects of Diamox (6063), a New Carbonic Anhydrase Inhibitor , Tr. New York Acad. Sc. 15:53, 1952.Crossref 7. Friedberg, C. K.; Taymor, R.; Minor, J. B., and Halpern, M.: Use of Diamox, a Carbonic Anhydrase Inhibitor, as an Oral Diuretic in Patients with Congestive Heart Failure , New England J. Med. 248:883, 1953.Crossref 8. Kinsey, V. E.: Comparative Chemistry of Aqueous Humor in Posterior and Anterior Chambers of Rabbit Eyes , A. M. A. Arch. Ophth. 50:401, 1953.Crossref 9. Friedenwald, J. S.: Formation of the Intraocular Fluid , Am. J. Ophth. 32:9 (June, (Pt. 2) ) 1949. 10. Westrand, P. J.: Carbonic Anhydrase in the Anterior Uvea of the Rabbit , Acta physiol. scandinav. 24:144, 1951.Crossref 11. Bakker, A.: Carbonic Anhydrase and Cataracta Lentis , Brit. J. Ophth. 32:910, 1948.Crossref 12. Bakker, A.: Action of Sulphanilamide on Rabbits' Lenses in Vitro , Brit. J. Ophth. 31:216, 1947.Crossref 13. Kinsey, V. E.: A Unified Concept of Aqueous Humor Dynamics and the Maintenance of Intraocular Pressure , A. M. A. Arch. Ophth. 44:215, 1950.Crossref 14. Mansheim, B. J.: Aqueous Outflow Measurements by Continuous Tonometry in Some Unusual Forms of Glaucoma , A. M. A. Arch. Ophth. 50:580, 1953.Crossref 15. Maren, T. H., and Wadsworth, B. C.: Relation Between the Pharmacological Disposition and the Renal Effects of Diamox (a-Acetylamino-1, 3, 4-Thiadiazole-5-Sulfonamide), a Carbonic Anhydrase Inhibitor , J. Pharmacol. & Exper. Therap. 110:34, 1954. 16. Maren, T. H.: Blocking of the Renal Effect of Diamox (2-Acetylamino-1, 3, 4-Thiadiazole-5-Sulfonamide) by Metabolic Acidosis , Fed. Proc. 13:383, 1954. 17. Becker, B.: Decrease in Intraocular Pressure in Man by a Carbonic Anhydrase Inhibitor, Diamox , Am. J. Ophth. 37:13, 1954.
A.M.A. Archives of Ophthalmology – American Medical Association
Published: Sep 1, 1954
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