Copyright 2017 Wolters Kluwer All Rights Reserved Carbonic Anhydrase Inhibitors

Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors Carbonic Anhydrase Inhibitors • Actions – Block the effects of carbonic anhydrase; slow down the movement of hydrogen ions – More sodium and bicarbonate are lost in the urine • Indications – Adjuncts to other diuretics – Glaucoma

Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors (cont.) Carbonic Anhydrase Inhibitors (cont.) • Pharmacokinetics – Rapidly absorbed and widely distributed – Excreted in the urine • Contraindications – Allergy – Angle closure glaucoma

Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors (cont.) Carbonic Anhydrase Inhibitors (cont.) • Caution – Lactation – Fluid or electrolyte imbalances – Renal or hepatic disease – Adrenocortical insufficiency – Respiratory acidosis – COPD

Copyright © 2017 Wolters Kluwer • All Rights Reserved Carbonic Anhydrase Inhibitors (cont.) Carbonic Anhydrase Inhibitors (cont.) • Adverse Effects – Related to disturbances in acid and base balance and electrolyte balances – Metabolic acidosis – Hypokalemia – Paresthesias of extremities, confusion, drowsiness • Drug-to-Drug Interactions – Salicylates and lithium

Copyright © 2017 Wolters Kluwer • All Rights Reserved Potassium-Sparing Diuretics Potassium-Sparing Diuretics • Not as powerful as the loop diuretics, but they retain potassium instead of wasting it. • Amiloride ( Midamor ) • Spironolactone ( Aldactone ) • Triamterene ( Dyrenium )

Copyright © 2017 Wolters Kluwer • All Rights Reserved Potassium-Sparing Diuretics Potassium-Sparing Diuretics • Actions – Cause a loss of sodium while retaining potassium – Block the actions of aldosterone in the distal tubule • Indications – Adjuncts with thiazide or loop diuretics – Patients who are at risk for hypokalemia • Pharmacokinetics – Well absorbed, protein bound, and widely distributed – Metabolized in the liver and excreted in the urine

Copyright © 2017 Wolters Kluwer • All Rights Reserved Potassium-Sparing Diuretics (cont.) Potassium-Sparing Diuretics (cont.) • Contraindications – Allergy – Hyperkalemia, renal disease, or anuria – Patients taking amiloride or triamterene • Caution – Pregnancy and lactation • Adverse Effects – Hyperkalemia • Drug-to-Drug Interactions – Salicylates