Carbonic Anhydrase Inhibitors (CAIs) - diuretics
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- inhibit activity of enzyme carbonic anhydrase (found in kidneys, eyes, and other parts of body)
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- work at the location of the carbon anhydrase enzyme system along nephron (primarily proximal tubule
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- Medications: Acetazolamide
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- treatment of glaucoma
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- edema
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- high-altitude sickness symptoms (headache, nausea, shortness of breath, dizziness, drowsiness, fatigue)
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- adjunct drugs in long-term management of open-angle glaucoma
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- short term in conjunction with miotics to lower intraocular pressure in preparation for ocular surgery
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- adjunct in treatment of secondary glaucoma
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- manage edema secondary to heart failure that has become resistant to other diuretics
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- digoxin: hypokalemia, toxicity
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- corticosteroids: hypokalemia
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- amphetamines, carbamazepine, cyclosporine, phenytoin, and quinidine: effects may be increased
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- increase sodium excretion by decreasing sodium-hydrogen ion exchange throughout the renal tubule
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- can induce respiratory and metabolic acidosis --> increase oxygenation by increasing ventilation
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- also decrease secretion of aqueous humor in the eye and thus decrease intraocular pressure
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- elevation of blood glucose level and glycosuria in diabetic patients
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- reduce formation of hydrogen and bicarbonate ions from carbon dioxide and water through inhibition of carbonic anhydrase activity - results in availability of ions (hydrogen)
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- drug allergy
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- severe renal or hepatic dysfunction
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- hyponatremia
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- adrenal gland insufficiency
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- hypokalemia
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- cirrhosis
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- metabolic abnormalities (ex: acidosis and hypokalemia)
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- drowsiness
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- anorexia
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- paresthesias
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- hematuria
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- urticaria
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- photosensitivity
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- melena (blood in stool)
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