Hemodialyzability of acetazolamide

Area of Science:

• Pharmacokinetics
• Nephrology
• Toxicology

Background:

• The dialyzability of acetazolamide, a carbonic anhydrase inhibitor, is not well-established.
• Understanding drug removal during dialysis is crucial for managing overdoses and specific patient populations.

Purpose of the Study:

• To determine the in vivo dialysance of acetazolamide.
• To assess the efficacy of hemodialysis in removing acetazolamide from the body.

Main Methods:

• In vivo study to measure acetazolamide dialysance.
• Intravenous administration of acetazolamide followed by hemodialysis.
• Calculation of drug removal percentage and acetazolamide/urea nitrogen extraction ratio.

Main Results:

• Acetazolamide dialysance averaged 22 ml per minute.
• Approximately 30% of the administered acetazolamide dose was removed within four hours of hemodialysis.
• An acetazolamide/urea nitrogen extraction ratio of 0.16 was established.

Conclusions:

• Hemodialysis can significantly remove acetazolamide, despite its high distribution within red blood cells and plasma protein binding.
• Hemodialysis may be a viable treatment option for acetazolamide overdose, particularly in cases of renal failure.
• The established extraction ratio can predict acetazolamide dialysance under varying dialysis conditions.