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The drug is occasionally used on an intermittent basis to prevent seizures in catamenial epilepsy. [10] The sulfur-containing antiseizure and antimigraine drug topiramate is a weak inhibitor of carbonic anhydrase, particularly subtypes II and IV. [11] Whether carbonic anhydrase inhibition contributes to its clinical activity is not known.
Dichlorphenamide as a carbonic anhydrase inhibitor is used for the treatment of acute angle closure glaucoma. While Dichlorphenamide does contain two sulfate groups within the structure, it falls under the class of a first generation carbonic anhydrase Inhibitor.
For example, carbonic anhydrase produces acid in the stomach lining. In the kidney, the control of bicarbonate ions influences the water content of the cell. The control of bicarbonate ions also influences the water content in the eyes. Inhibitors of carbonic anhydrase are used to treat glaucoma, the excessive build-up of water in the eyes.
Acetazolamide is a carbonic anhydrase inhibitor, hence causing the accumulation of carbonic acid. [12] Carbonic anhydrase is an enzyme found in red blood cells and many other tissues that catalyses the following reaction: [26] H 2 CO 3 ⇌ H 2 O + CO 2. hence lowering blood pH, by means of the following reaction that carbonic acid undergoes: [27]
Rarely, the inhibition of carbonic anhydrase may be strong enough to cause metabolic acidosis of clinical importance. [44] The U.S. Food and Drug Administration (FDA) has notified prescribers that topiramate can cause acute myopia and secondary angle closure glaucoma in a small subset of people who take topiramate regularly. [45]
It is a carbonic anhydrase inhibitor and works by decreasing the production of aqueous humor. [3] Dorzolamide was approved for medical use in the United States in 1994. [3] It is available as a generic medication. [5] In 2022, it was the 201st most commonly prescribed medication in the United States, with more than 2 million prescriptions. [6] [7]
Zonisamide and other carbonic anhydrase inhibitors such as topiramate, furosemide, and hydrochlorothiazide have been known to interfere with amobarbital, which has led to inadequate anesthetization during the Wada test. [21] Zonisamide may also interact with other carbonic anhydrase inhibitors to increase the potential for metabolic acidosis. [5]
Carbonic anhydrase IX (CA9/CA IX) is an enzyme that in humans is encoded by the CA9 gene. [ 5 ] [ 6 ] [ 7 ] It is one of the 14 carbonic anhydrase isoforms found in humans and is a transmembrane dimeric metalloenzyme with an extracellular active site that facilitates acid secretion in the gastrointestinal tract. [ 8 ]