Rr.

Widyastuti Pusparini
decrease aqueous humor production

inhibiting the activity of ciliary epithelial

carbonic anhydrase

Systemic CAI  further decrease aqueous

humor formation  resultant renal metabolic
acidosis, which may interfere with activity of
ciliary epithelial Na+,K+- ATPase
 Diffusion

Ultrafiltrati
on

Active
secretion
 Diffusion occurs when solutes, especially lipid soluble
substances, are transported through the lipid portions of the
membrane of the tissues between the capillaries and the
posterior chamber, proportional to a concentration gradient
across the membrane
 Reducing
Inhibit enzim
aqueous
carbonic Lower IOP
humor
anhydrase
formation
 • dorzolamide (3 times daily)
Topical • Brinzolamide (3 times daily)

• acetazolamide (250 mg 4 times a day)

• methazolamide (25–50 mg, given 2 or 3 times daily)
Systemic • Oral CAIs begin to act within 1 hour of administration,
with maximal effect within 2–4 hours (vs IV CAI’s  15
mins)

• Orally or intravenously are most

Indications useful in acute situations (eg,
acute primary angle closure)
 • bitter taste, burning in instillation, punctate keratopathy,
red vision
Topical

• Paresthesias of the fingers or toes

• Loss of energy and anorexia.
Systemic • Weight loss is common.
• Severe mental depression

• Abdominal discomfort, diarrhea,

• Loss of libido, impotence
• Taste disturbance
• Sickle cell anemia
Systemic • Renal stones
• Hypokalemia
 hepatic Sulfa
cirrhosis allergies

Contraindicati
ons