Aspirin Adverse Effect: salicylate toxicity (vomiting, tachycardia, hyperpnea, mental confusion) or acetazolamide toxicity (fatigue, lethargy, somnolence, confusion, hyperchloremic metabolic acidosis)Clinical Management: If used concurrently (especially in patients with renal dysfunction or receiving large doses of aspirin), monitor for salicylate toxicity.
DigoxinAdverse Effect: Digoxin toxicity (nausea, vomiting, arrhythmias) Clinical Management: If concurrent therapy is required, monitor the patients electrolytes carefully, particularly potassium, and assess the need for electrolyte (ie, potassium) replacement therapy.
Lithium Adverse Effect: Decreased lithium effectiveness or increased lithium concentrationsClinical Management: Monitor therapeutic efficacy of lithium and serum lithium concentrations. Adjustments of the lithium dose may be necessary.
PhenytoinAdverse Effect: An increased risk of osteomalacia Clinical Management: If acetazolamide and phenytoin therapy are to be coadministered, monitor patients for early signs of osteomalacia. Treatment of osteomalacia includes withdrawal of acetazolamide and administration of vitamin D and phosphate.
QuinidineAdverse Effect: quinidine toxicity (ventricular arrhythmias, hypotension, aggravated CHF)Clinical Management: If initiating, discontinuing, or changing the dose of acetazolamide in patients taking quinidine, monitor quinidine levels and adjust quinidine dose as required.
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