Due to the abundance of readily-bound erythrocytes and minimal known metabolism, Brinzolamides whole blood half-life is very long (111 days). Metabolism
While definitive sites of metabolism have not been firmly established, there are several metabolites worthy of note. N-Desethylbrinzolamide is an active metabolite of the parent compound, and thus exhibits carbonic anhydrase inhibitory activity (largely carbonic anhydrase-I, when in the presence of Brinzolamide) and also accumulates in the erythrocytes. However, Brinzolamides other known metabolites (N-Desmethoxypropylbrinzolamide and O-Desmethylbrinzolamide) either have no activity or their activity is currently unknown. Excretion
Brinzolamide is excreted primarily unchanged (60%) in the urine, although the renal clearance rate has not been definitively determined. N-Desethylbrinzolamide is also found in the urine along with lower concentrations of the inactive metabolites, N-Desmethoxypropylbrinzolamide and O-Desmethylbrinzolamide; exact levels have not been definitively determined. Cautions
Side effects
Common, but mild: blurred vision; bitter, sour, or unusual taste; itching, pain, watering, or dryness of the eyes; feeling that something is in the eye; headache; runny nose
Rare, but serious: fast or irregular heartbeat; fainting; skin rash, hives, or itching; severe eye irritation, redness, or swelling; swelling in the face, lips, or throat; wheezing or trouble breathing

Precautions
Hypersensitivity to other sulfonamides
Acute angle-closure glaucoma
Concomitant administration of oral carbonic anhydrase inhibitors
Moderate-to-severe chronic kidney disease or liver disease

Combinations
With timolol
The combination of brinzolamide with timolol is marketed under the trade name Azarga. This combination may be more effective than either medication alone. With brimonidine
The combination of brinzolamide with brimonidine is marketed under the trade name Simbrinza. This combination may be more effective than either medication alone. References
Further reading
External links
"Brinzolamide".
Diaphragmatic hernia is a defect or hole in the diaphragm that allows the abdominal contents to move into the chest cavity. Treatment is usually surgical. Types
Congenital diaphragmatic hernia
Morgagnis hernia
Bochdalek hernia
Hiatal hernia
Iatrogenic diaphragmatic hernia
Traumatic diaphragmatic hernia

Signs and symptoms
A scaphoid abdomen (sucked inwards) may be the presenting symptom in a newborn. Diagnosis
Diagnosis can be made by either CT or X-ray. Treatment
Treatment for a diaphragmatic hernia usually involves surgery, with acute injuries often repaired with monofilament permanent sutures. Other animals
Peritoneopericardial diaphragmatic hernia is a type of hernia more common in other mammals. This is usually treated with surgery. References
Bibliography
Eren S, Ciris F (2005). "Diaphragmatic hernia: diagnostic approaches with review of the literature". Eur J Radiol. 54 (3): 448–59. doi:10.1016/j.ejrad.2004.09.008. PMID 15899350. == External links ==