• Administration and Dosage
• Adverse Effects
• Therapeutic Use
• Toxicity

• Anticonvulsant
  (Drugs used to prevent seizures or reduce their severity.)
• Carbonic Anhydrase Inhibitor
  (A class of compounds that reduces the secretion of H+ ions by the proximal kidney tubule through inhibition of carbonic anhydrases.)
  
• Diuretic
  (Agents that promote the excretion of urine through their effects on kidney function.)

A role of salivary carbonic anhydrase VI in dental plaque.

Arch Oral Biol. 2006 Feb;51(2):117-22

Authors: Kimoto M, Kishino M, Yura Y, Ogawa Y

OBJECTIVE: Carbonic anhydrase (CA) VI is a unique secreted isozyme of CA, which catalyzes the reversible reaction CO2 +H2O<-->H+ +HCO3-. CA VI has been thought to provide a greater buffering capacity to fluids into which it is secreted. This study was performed to confirm this in saliva. DESIGN: Nine healthy subjects participated in the study. The pH of the dental plaque from each subject was monitored after a mouth rinse with 10% sucrose with or without 10(-5)M acetazolamide, a specific inhibitor of CA. Also CA was examined in plaque by enzyme histochemistry, immunohistochemistry and Western blot analysis. RESULTS: Though sucrose and sucrose plus inhibitor yielded Stephan curves with a similar temporal pattern, the pH values of the latter were significantly lower than those of the former. Plaque exhibited CA activity by enzyme histochemistry. Immunohistochemistry and Western analysis demonstrated that the activity was due to CA VI but not to CA I or CA II. CONCLUSIONS: The results indicate that CA VI in saliva penetrates plaque and facilitates acid neutralization by salivary bicarbonate. Therefore, CA VI may be considered an anti-caries protein in saliva.

PMID: 15961059 [PubMed - indexed for MEDLINE]

[Drug therapy for sleep apnea syndrome]

Nippon Rinsho. 2000 Aug;58(8):1671-4

Authors: Takahashi Y, Shimizu T

The number of patients suffering from sleep apnea syndrome(SAS) have been increased. In recent years, many therapeutic approaches such as nasal CPAP, dental appliance, upper airway surgery, pharmacological agents, have been used for the treatment of SAS. The various drugs(acetazolamide, some tricyclic antidepressant, progesterone, theophylline, aminophylline and so on) have been used for pharmacotherapy of SAS. Acetazolamide have been established as the best medication. But all approaches without acetazolamide, could not shown their satisfactory effects on SAS. In this article, drug therapy for SAS is described.

PMID: 10944932 [PubMed - indexed for MEDLINE]

[Sleep apnea syndrome (SAS)]

Nippon Rinsho. 1998 Feb;56(2):382-8

Authors: Okada T

In recent years, there has been rapid progress in the pathophysiology, diagnostic methods and therapeutics of sleep apnea syndrome (SAS). In this article, we present our findings in these fields for the past several years. Recently, we have been able to use ultralow-field magnetic resonance (MR) fluoroscopy to visualize the upper airway for extended periods of time. The severity of SAS should be evaluated by precise history taking, physical and laboratory examination and polysomnography together with SpO2 and esophageal pressure monitoring. Treatment strategy includes multidisciplinary approaches, life style modification and suitable treatment choice, such as CPAP, dental appliance, upper airway surgery, pharmacological agents.

PMID: 9503839 [PubMed - indexed for MEDLINE]

[Treatment of obstructive sleep apnea syndrome with a mandibular positioning device and other nonsurgical modalities]

Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Dec;33 Suppl:76-84

Authors: Sakakibara H, Umemoto M, Kuwahara M, Suetsugu S

The therapeutic approach to a patient with obstructive sleep apnea syndrome (OSAS) must be individualized because of the heterogeneity in the pathogenesis of the disorder. Although nasal continuous positive airway pressure (CPAP) is effective no matter what the pathogenesis, risk factors for this disorder should be identified in each patient. Nasal CPAP will be discussed by others. Weight loss is one of the best nonsurgical treatments of OSAS and it should be strongly recommended to obese patients with the disorder, even though only a few achieve satisfactory weight reduction. Sleeping in the lateral position or upright may be effective in some patients with OSAS. Acetazolamide, medroxyprogesterone, or protriptyline may also have a role in some patients, although the efficacy must be weighed against the considerable side effects. The cross-sectional area of the oropharynx measured by computed tomography in patients with OSAS was significantly lower than that in control subjects. Lateral cephalograms revealed a retarded mandible in many patients. A dental device designed to advance the mandible 2 to 7 mm and to eliminate the airway obstruction at the base of tongue was used in 20 consecutive patients (17 men and 3 women, average age 53.8 years) to treat the obstructive sleep apnea. The body mass index of the patients was 27.6 +/- 4.2 kg/m2 (mean +/- SD). The device moved the mandible forward (p = 0.038) and increased the airway space in the lower part of the oropharynx (p = 0.031) as assessed with lateral cephalograms. After nightly use of the device for 24 to 211 days, overnight polysomnography was performed for two nights: without the device for the first night and with it for the second night. The apnea index was reduced from an average of 30.7 to 18.5 events/hour (60.4% of the pretreatment value, p = 0.004). The number of desaturations (more than 5% decrease from the base line SaO2) decreased and the lowest level of SaO2 increased: from 26.5 to 14.4 events/hour (p = 0.009) and from 63.6 to 70.1% (p = 0.005), respectively. Not every patient improved sufficiently. Eleven of 20 patients were classified as good responders, because of a reduction in apnea index of at least 50% of the pretreatment value, and the remaining nine patients were classified as poor responders. Use of the device reduced the severity ratings of snoring and excessive daytime sleepiness not only in the good responders but also in the poor responders. No serious complications were observed. The mandibular positioning device is an effective treatment for some patients with OSAS. The effectiveness of the device should be predicted from polysomnographic and cephalometric data, and from CT measurements of the upper airway and other characteristics of the patients.

PMID: 8752487 [PubMed - indexed for MEDLINE]

Symposium on clinical aspects of sleep-disordered breathing and circulation. Treatment.

Intern Med. 1995 Apr;34(4):316-7

Authors: Kuriyama T

PMID: 7606114 [PubMed - indexed for MEDLINE]

Histochemical demonstration of carbonic anhydrase activity in the odontogenic cells of the rat incisor.

J Dent Res. 1988 Oct;67(10):1271-4

Authors: Sugimoto T, Ogawa Y, Kuwahara H, Shimazaki M, Yagi T, Sakai A

Aldehyde-fixed, EDTA-demineralized frozen sections of the rat maxillary incisor were histochemically stained for carbonic anhydrase activity, by use of Hansson's method. Intense staining was observed in the odontoblasts, all types of epithelial cells of enamel organ in the maturation zone, cementoblasts, and the cells of the lingual dental sac. Less intense but consistent staining was observed in all types of epithelial cells of odontogenic origin directly facing the pulp and pulp cells adjacent to the odontoblast cell layer in the apical part of the pulp, and was considered due to the carbonic anhydrase-catalyzed reaction. Staining of these cells was completely inhibited by heat pretreatment (120 degrees C, 30 min), 10(-6) mol/L acetazolamide in the incubation medium, incubation by continuous immersion under the liquid surface, and omission of the substrate, NaHCO3. The dentin also exhibited heavy staining which was inhibited by the heat pre-treatment. However, this dentinal staining resisted the inhibition by 10(-3) mol/L acetazolamide and was not inhibited by incubation by continuous immersion or incubation without the substrate NaHCO3. The dentinal staining was thus judged to have been due to non-enzymatic cobalt precipitation.

PMID: 3139725 [PubMed - indexed for MEDLINE]

Some properties of carbonic anhydrase from mineralizing hamster molars.

J Biol Buccale. 1985 Mar;13(1):19-25

Authors: Dogterom AA, W&#xF6;ltgens JH

Carbonic anhydrase (CA) activity in mineralizing hamster molars was determined with a radiochemical assay. Hamster molar CA appeared to be very similar to CA from other sources. No pH optimum could be determined; the KM was 13.6 mM and CA was strongly inhibited by acetazolamide. EDTA and F- had almost no effect on the CA activity. This lack of fluoride effect suggests strongly that the protective effect of fluoride on dental mineral is not mediated by CA.

PMID: 3921532 [PubMed - indexed for MEDLINE]

Congenital persistent proximal type renal tubular acidosis in two brothers.

Acta Paediatr Scand. 1979 Nov;68(6):861-8

Authors: Winsnes A, Monn E, Stokke O, Feyling T

Two brothers showed severe and persistent hyperchloraemic metabolic acidosis (capillary blood pH 7.07--7.15) due to a low renal bicarbonate threshold at 11 mmol/l. The maximal tubular capacity for bicarbonate reabsorption was reduced to about half the normal. A high dose of acetazolamide (25 mg/kg) lowered the tubular bicarbonate reabsorption substantially, indicating the presence of carbonic anhydrase. Both the glomerular filtration rate, the renal blood flow and the renal concentrating capacity were slightly reduced. The clinical characteristics were: growth retardation, mental retardation, nystagmus, corneal opacities, cataract, glaucoma and enamel defects of the permanent teeth. Serum thyroxine was pathological low without clinical signs of hypothyreosis. The erythrocytes showed an increased osmotic resistance. Autopsy of the younger brother, who died 4 1/2 years old, revealed thyroid and thymus weights of 25% of the normal. The kidney tubular cells were swollen with vacuoles. The glomeruli had a normal appearance.

PMID: 44068 [PubMed - indexed for MEDLINE]

Effect of 2-acetylamino-1,3,4-thiadiazole-5-sulfonamide (diamox) on dental caries resistance in hamsters.

J Dent Res. 1957 Jun;36(3):372-4

Authors: MITCHELL DF, JOHNSON MJ

PMID: 13428892 [PubMed - OLDMEDLINE for Pre1966]