Carbonic Anhydrase Inhibitors

The prototype for this subclass of diuretic is acetazolamide, which is a nonbacteriostatic sulfonamide whose adverse reactions include severe allergic reaction and Stevens-Johnson syndrome. The primary action of this class of diuretic is to inhibit carbonic anhydrase in the kidney to prevent the reversible reaction of carbon dioxide and water to form carbonic acid. This results in loss of bicarbonate ions in the urine, along with sodium, potassium, and water. Overdose with this class of medication can lead to volume depletion and electrolyte disturbances, as well as non-anion-gap metabolic acidosis. Treatment is directed at reversing volume depletion, monitoring electrolytes, and restoring normal pH balance.

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