Diamox & Emphysema

Many different disease states can be worsened by medications. This is known as a drug-disease state interaction and occurs when a medication has a side effect that significantly worsens an individual's disease. One such interaction occurs when patients with severe lung disease, like emphysema, take a medication called Diamox.

Emphysema

• Cigarette smoking can lead to emphysema.

  Emphysema is a form of chronic lung disease that is most often due to cigarette smoking. In this particular form of lung disease, the tiny air sacs in the lungs, called alveoli, have been damaged. The alveoli are made of thin, delicate membranes and are responsible for the exchange of oxygen and carbon dioxide between the air we breathe and our blood. When the alveoli are damaged, carbon dioxide and oxygen cannot be easily exchanged, and carbon dioxide builds up in the blood. Patients with emphysema have difficulty breathing, so they often feel fatigued and short of breath and may have other symptoms like coughing or wheezing.

Diamox

• Diamox (pronounced dye-ah-mox) is the brand name of a medication also known as acetazolamide (ah-ceet-ah-zol-ah-myde). This medication is used to treat several medical conditions including glaucoma, edema or swelling caused by heart failure, certain types of seizure disorders and mountain or altitude sickness. Acetazolamide works primarily by inhibiting an enzyme in the body that converts carbon dioxide dissolved in the blood to bicarbonate.

Carbon Dioxide

• Carbon dioxide, or CO2, is a waste product of our normal metabolism and is usually eliminated from the body through the lungs or is converted to bicarbonate (HCO3) by enzymes and is excreted by the kidneys in the urine. Diamox prevents the conversion of carbon dioxide to bicarbonate and leads to increasing levels of carbon dioxide in the blood. In a healthy individual, the lungs would be capable of eliminating the extra carbon dioxide simply by breathing faster. In persons with chronic lung diseases, however, the damaged lungs are incapable of responding to the increased carbon dioxide levels, and the carbon dioxide builds up in the blood. Carbon dioxide is an acidic substance, and increased carbon dioxide in the blood can lead to a dangerous condition called acidosis.

Symptoms of Acidosis

• When the pH balance of the body is too low, such as in acidosis, the most common presenting symptom is heavy, rapid breathing. Because people with lung disease may not be able to increase their rate or depth of breathing, this symptom may be absent. Instead, look for symptoms like nausea, vomiting, headache or confusion and drowsiness. The drowsiness and confusion may progress to coma or death if the acidosis is not treated quickly.

Warnings and Precautions

• Patients with chronic diseases can experience devastating side effects when they take medications that are harmful to their condition. It is vital that individuals with chronic diseases do not take any medications unless on the advice of a licensed physician, and patients should provide each of their physicians and their pharmacist with a complete medication list and disease history.