This is a very powerful diuretic class but it only works for 3 days and it’s intended for hospital use only. They cause an increase in loss of carbonate in the urine and there’s an associated loss of sodium.
Therapeutic Uses
- Short term diuretic effect: The reason it only works for three days is because as a person losse bicarbonate, the person becomes acidic. As a person becomes metabolically acidic, the lungs kick in by breathing faster! So then you get a compensatory respiratory alkalosis. So when that balance gets corrected, we no longer have diuresis.
- Long term glaucoma:Â Another use is to lower intra-ocular pressure and this has an indefinite benefit and works for a long period of time (not limited to 3 days).
Toxicities
- Drowsiness
- Metabolic acidosis
Carbonic Anhydrase Inhibitors
These are easy to recognize because they all end in -zolamide.
Acetazolamide (Diamox) – p.o., inj.
Methazolamide (Neptazine) – p.o.
Dorzolamide (Trusopt) – ophthalmic drop. Preferred for glaucoma because it’s an eye drop and therefore has less systemic side effects.
