Acetazolamide

Acetazolamide is a carbonic anhydrase inhibitor. It works by inhibiting carbonic anhydrase activity, thereby reducing the reabsorption of bicarbonate (HCO₃⁻) and increasing the excretion of sodium, potassium, and water. In the proximal convoluted tubule of the kidney, acetazolamide increases bicarbonate excretion, makes the urine more alkaline, shifts the blood toward metabolic acidosis, and produces a mild diuretic effect. In the ciliary body of the eye, it reduces the movement of sodium and water into the aqueous humor, decreases aqueous humor production, and lowers intraocular pressure. In the brain, the mild metabolic acidosis it induces can reduce neuronal excitability.