Periodic Paralyses Medication

Updated: Apr 30, 2018
  • Author: Naganand Sripathi, MD; Chief Editor: Nicholas Lorenzo, MD, CPE, MHCM, FAAPL  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.


Carbonic anhydrase inhibitors

Class Summary

Carbonic anhydrase (CA) is an enzyme found in many tissues of the body, including the eye. It catalyzes a reversible reaction whereby carbon dioxide becomes hydrated and carbonic acid dehydrated.

Dichlorphenamide (Keveyis)

Carbonic anhydrase inhibitor, but the exact mechanism by which dichlorphenamide is able to treat periodic paralysis is unknown. Inhibits H+ ion excretion in renal tubule, resulting in increased sodium, potassium, bicarbonate, and water excretion and producing alkaline diuresis. It is indicated for primary hyperkalemic periodic paralysis, primary hypokalemic periodic paralysis, and related variants.

Acetazolamide (Diamox)

Exact mechanism of action unknown. In hypokalemic PP, may decrease potassium inflow to muscle because of metabolic acidosis. In hyperkalemic PP, kaliopenic effect of CA inhibitors may be beneficial. Recent data suggest carbonic anhydrase inhibitors activate skeletal muscle BK channel (Ca2+ -activated potassium channel).