Aamir Malik
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One of the adverse effect of Carbonic Anhydrase Inhibitor ( Acetazolamide ) Is HYPERCHLOREMIA. why there is increase blood level of Cl . please explain thanks
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| drsnq
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which I understand acetazolamide does not cause inc chloride in the blood...It cause hyperchlormic metabolic acidosis ,not hyperchloremia...
mechanesim of hyperchloremic metabolic acidosis...CA (present in ptubuler epithelium of proximal convoluted epithelium)catalyzes the reaction of CO2+ H2O =H2CO3 both in epithelial cell of renal tubules and lumen as well..after formation of H2CO3 (in epithelial cell)it degrade in to Hydrogen ion and Hco3-(bicarbonate) which enter in to the blood while H+ enter in to the lumen with exchange of Na with this mechanism Na will enter in to the blood ...the H ion which enter with exchange of Na is then react with lumenal HCO3- and forn H2CO3 which then form H2) and CO2 in lumen
If CA inhibited by acetazolamide this reaction will not produce H+ for Na exchange ..result in mild diuresis while(luminal) HCO3- retained in the lumen (because there is no H ion available for the formation of H2CO3)..this retained HCO3- will increases the urinary pH and loss in the urine ..this loss cause a hyperchloremic metabolic acidosis
I hope this help
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| mjl1717
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Just for fun: In what clinical situations would you use acetozolamide.??
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| sturge_weber
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glaucoma
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| drsnq
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yeah glaucoma,urinary alkalinization,metabolic alkalosis,altitude sickness
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| Dragonfly
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also for Mienier`s disease of the endolymph and seizure (it reduces the seizure threshold via inhib. myelin+ glial CA)
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