Acetazolamid

Acetazolamide is a carbonic anhydrase inhibitor used as a diuretic and in the treatment of several medical conditions. It decreases bicarbonate reabsorption in the proximal tubule of the kidney and reduces bicarbonate production in the eye. The resulting bicarbonaturia and mild metabolic acidosis contribute to lower intraocular pressure and can alleviate symptoms in certain disorders.

Medical uses include open-angle glaucoma, where it lowers intraocular pressure; prevention or treatment of acute mountain sickness and other forms of metabolic or respiratory alkalosis; and as an adjunct in certain seizure disorders. It is also used in idiopathic intracranial hypertension to help reduce elevated intracranial pressure.

Pharmacology and administration: acetazolamide is typically given orally and can be administered intravenously in some settings. It is generally well absorbed, distributed, and eliminated primarily by the kidneys, with dosing and administration tailored to the condition and kidney function. Dose adjustments are often required in renal impairment.

Safety and adverse effects: common side effects include paresthesias, fatigue, nausea, and altered taste. It can cause potassium loss or metabolic acidosis, and may increase the risk of kidney stones in susceptible individuals. Hypersensitivity to sulfonamides is a consideration in selecting therapy. Caution is advised in patients with significant kidney disease, liver disease, electrolyte disturbances, or pregnancy unless benefits justify use. Drug interactions may occur with other diuretics, carbonic anhydrase inhibitors, and agents affecting acid–base balance.

Overview: acetazolamide is a well-established, broad‑spectrum agent with specific roles in ophthalmology, neurology, and altitude-related conditions, but its use requires consideration of renal function and electrolyte status.