Acetazolamide is contraindicated in which condition?

Acetazolamide is contraindicated in which condition?

• A. Renal failure
• B. Hepatic failure
• C. Diabetes mellitus
• D. Hyperkalemia

Answer: (A)

Acetazolamide blocks carbonic anhydrase in the proximal tubule, which reduces bicarbonate reabsorption and causes bicarbonaturia with a mild diuresis. This leaves the patient with a metabolic acidosis. The drug’s safety and effectiveness depend on functioning kidneys to excrete it and to help manage the bicarbonate loss. In renal failure, the drug can build up and the body’s ability to compensate for the bicarbonate loss is impaired, making metabolic acidosis worse and increasing the risk of adverse effects. Because of these risks, acetazolamide is contraindicated when kidney function is significantly impaired. The other conditions listed do not inherently require avoiding this medication.

Acetazolamide blocks carbonic anhydrase in the proximal tubule, which reduces bicarbonate reabsorption and causes bicarbonaturia with a mild diuresis. This leaves the patient with a metabolic acidosis. The drug’s safety and effectiveness depend on functioning kidneys to excrete it and to help manage the bicarbonate loss. In renal failure, the drug can build up and the body’s ability to compensate for the bicarbonate loss is impaired, making metabolic acidosis worse and increasing the risk of adverse effects. Because of these risks, acetazolamide is contraindicated when kidney function is significantly impaired. The other conditions listed do not inherently require avoiding this medication.