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Metabolic acidosis induced by acetazolamide
A Sporn1, D M Scothorn, J E Terry
1Department of Veterans Affairs Medical Center, Huntington, WV.
Journal of the American Optometric Association
|December 1, 1991
Summary
Carbonic anhydrase inhibitors like acetazolamide lower eye pressure but can cause metabolic acidosis. Patients with lung or kidney issues require close monitoring for this serious side effect.
Area of Science:
- Ophthalmology
- Pharmacology
- Nephrology
Background:
- Carbonic anhydrase inhibitors (acetazolamide, methazolamide) are common ophthalmic drugs.
- These drugs reduce intraocular pressure by decreasing aqueous humor production.
- They act as weak systemic diuretics.
Observation:
- A significant side effect is the potentiation or exacerbation of metabolic acidosis.
- The severity of acidosis can range from transient to serious, depending on patient health.
- This case involves a patient with chronic obstructive pulmonary disease and a history of nephrectomy.
Findings:
- Metabolic acidosis is a critical adverse effect of carbonic anhydrase inhibitors.
- Pre-existing conditions like COPD and nephrectomy increase patient risk.
- Careful monitoring is essential for patients on these medications.
Implications:
- Physicians must carefully weigh the benefits against the risks of carbonic anhydrase inhibitors.
- Patient selection and close monitoring are crucial, especially for those with comorbidities.
- Understanding potential side effects like metabolic acidosis is vital for ophthalmic practitioners.