asetazolamid

Asetazolamid, commonly spelled acetazolamide, is a medication that belongs to the class of carbonic anhydrase inhibitors. It is a sulfonamide derivative used in several clinical settings, most notably in the management of glaucoma, altitude sickness, and certain types of edema. The name acetazolamide is widely used in many countries, while some languages use the spelling asetazolamid.

Medical uses include lowering intraocular pressure in glaucoma, where the drug reduces the production of aqueous humor. It is also used for prevention and treatment of acute mountain sickness by inducing a mild metabolic acidosis that stimulates ventilation. In certain circumstances, it has been used to manage metabolic alkalosis and some forms of edema, particularly where other diuretics are unsuitable or insufficient. It may be prescribed as part of a short-term treatment plan under physician supervision.

Mechanism of action involves inhibition of the enzyme carbonic anhydrase in both the eye and the proximal tubule of the kidney. In the eye, reduced carbonic anhydrase activity lowers aqueous humor formation, decreasing intraocular pressure. In the kidney, bicarbonate reabsorption is inhibited, causing bicarbonate, sodium, and water loss (diuresis) and a mild metabolic acidosis.

Administration and pharmacokinetics: acetazolamide is available orally and by intravenous administration. It is rapidly absorbed, with effects typically occurring within a few hours. It is primarily excreted unchanged by the kidneys, so renal function affects dosing and duration of action.

Adverse effects and precautions: common side effects include paresthesias, fatigue, and altered taste. Metabolic acidosis, hypokalemia, and the formation of kidney stones can occur due to alkaline urine. Hypersensitivity to sulfonamides and severe renal impairment are contraindications. Use during pregnancy or breastfeeding requires medical advice. Patients should be monitored for fluid and electrolyte balance and adjusted dosing as needed.