Acetazolamide is an effective treatment for glaucoma as it reduces intraocular pressure. This drug inhibits the formation of bicarbonate in the eye, which draws in sodium, which is followed by water via osmositic potential. This is typically called the aqueous humor. Thus, acetazolamide reduces bicarbonate, leading to decreased aqueous humor in the eye.
This drug may be used in prophylaxis and treatment of altitude sickness. Acetazolamide works by decreasing bicarbonate stores, acidifying the bloods pH. This mechanism facilitates the renal compensation for respiratory alkalosis, allowing ventilation to increase without having respiratory alkalosis.
Acetazolamide may be indicated for treatment of pseudotumor cerebri, or idiopathic intracranial hypertension. Carbonic anhydrase inhibitors may be able to reduce the rate of cerebrospinal fluid production to lower pressure.
Acetazolamide may be used for diuresis when treating CHF-associated edema.
Because of acetazolamide's actions in reducing total body stores of HCO3-, it may be used to treat metabolic alkalosis.
Acetazolamide works by inhibiting carbonic anhydrase, interfering with bicarbonate absorption in the kidneys. Thus, the blood is acidified and the urine is alkalyzed.
Acetazolamide causes self-limited NaHCO3 diuresis, and reduces total body stores of HCO3-.
A side effect of acetazolamide use may be metabolic acidosis, as it causes reduction of total HCO3- body stores, acidifying the blood. Patients may also become hyperchloremic.
Another adverse effect of acetazolamide may be paresthesias, or tingling and numbness within the fingers and toes.
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