Systemic acidosis associated with diamox [abstract]

Glaucoma is an optic neuropathy defined by the presence of characteristic morphological alterations to the optic nerve head and suggestive visual field abnormalities. The aetiology of primary open angel glaucoma remains elusive but intraocular pressure is presumably the most important risk factor in all forms of glaucoma. In addition, the intraocular pressure remains the only modifiable risk factor, and current glaucoma therapy focusses on addressing the variable. A variety of drugs is available to reduce the intraocular pressure and they work by reducing aqueous production, increasing aqueous overflow or both. Although generally safe, these medications can be associated with local and systemic side effects. Topical beta blockers and systemic carbonic anhydrase inhibitors are notable for their effects on multiple organ systems and their potential for severe toxity. As with most medications, their safe use requires knowledge of the patient's health status, an awareness of specific contraindications to their use, sensitivity to the effects of ageing on drug metabolism, familarity with drugs which may cause adverse interaction and due diligence in the detection of insidious long-term effects. An illustrative case of marked acid-base imbalance associated with carbonic anhydrase inhibitor use is presented. (AU)

Acid-base status of adults with sickle-cell anaemia

Determinations of the acid-base status of 10 adult Jamaican patients with sickle-cell anaemia during "painful crisis" and after recovery showed no evidence of metabolic acidosis in the former, in contrast to reports from elsewhere. These results could explain the failure of alkalis to abort or alter the acute painful episodes of most patients with sickle-cell anaemia (AU)

Electrolyte and acid-base disturbances occurring in infantile gastro-enteritis in Jamaica

A preliminary investigation of electrolyte and acid-base disturbances occurring in infantile gastroenteritis in Jamaica is presented. As associated malnutrition was common it is felt the clinical assessment of dehydration remains more relible than laboratory methods in such cases. True hypertonicity was rare and so was hypocalcemia. Hypopotassemia was common but never associated with paralytic illness. A low serum magnesium level was common but usually asymptomatic. In four instances however, it apparently produced serious symptoms with potentially fatal possibilities. We therefore feel that magnesium supplements should be given along with potassium and other electrolytes in the crystalloid replacement therapy of such cases (AU)