Division of Nephrology, Virginia Commonwealth University Health System, Richmond, USA.
Cardiol Rev. 2011 Nov-Dec;19(6):276-8. doi: 10.1097/CRD.0b013e31822b4939.
Acetazolamide is the only carbonic anhydrase inhibitor with significant diuretic effects. It is readily absorbed and undergoes renal elimination by tubular secretion. Its administration is ordinarily marked by a brisk alkaline diuresis. Although carbonic anhydrase inhibitors are proximal tubular diuretics (where the bulk of sodium re-absorption occurs), their net diuretic effect is modest in that sodium re-absorption in more distal nephron segments offsets proximal sodium losses. Acetazolamide use is limited by both its transient action and the development of metabolic acidosis with extended administration. Acetazolamide can, however, correct the significant metabolic alkalosis which occasionally occurs with loop diuretic therapy.
乙酰唑胺是唯一具有显著利尿作用的碳酸酐酶抑制剂。它易被吸收，并通过肾小管分泌进行肾消除。其给药通常以快速碱性利尿为标志。虽然碳酸酐酶抑制剂是近端肾小管利尿剂（大部分钠重吸收发生在这里），但它们的净利尿作用是适度的，因为在更远端的肾单位段中钠的重吸收抵消了近端钠的丢失。乙酰唑胺的使用受到其短暂作用和长期给药时代谢性酸中毒发展的限制。然而，乙酰唑胺可以纠正与袢利尿剂治疗偶尔发生的显著代谢性碱中毒。
