Carbonic Anhydrase Inhibitors

The carbonic anhydrase inhibitors block the action of the enzyme carbonic anhy-drase which is needed to maintain the acid-base balance (hydrogen and bicarbonate ion balance). Inhibition of this enzyme causes increased sodium, potassium, and bicarbonate excretion. Prolonged use can result in metabolic acidosis.

Carbonic anhydrase inhibitors include acetazolamide dichlorphenamide (Diamox), and methazolamide (Daranide).

Carbonic anhydrase inhibitors are used to decrease intraocular pressure in patients with open-angle (chronic) glaucoma and are not used in narrow-angle or acute glaucoma. Other uses include inducing diuresis, management of epilepsy, and treatment of high-altitude or acute mountain sickness.

Carbonic anhydrase inhibitors can cause fluid and electrolyte imbalance, metabolic acidosis, nausea, vomiting, anorexia, confusion, orthostatic hypotension, and crystalluria. Hemolytic anemia and renal calculi can also occur. Carbonic anhydrase inhibitors are contraindicated in the first trimester of pregnancy.

A list of drugs for carbonic anhydrase inhibitors is provided in the Appendix. Detailed tables show doses, recommendations, expectations, side effects, contraindications, and more; available on the book's Web site (see URL in Appendix).

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