Acetazolamide

Acetazolamide is a medication that inhibits carbonic anhydrase enzymes. It is used for glaucoma, acute mountain sickness, certain forms of edema, and some seizure disorders.

Carbonic anhydrase: A family of enzymes that rapidly interconvert carbon dioxide and water with bicarbonate and hydrogen ions. Acetazolamide reduces activity of these enzymes, changing bicarbonate handling and fluid transport.
Glaucoma: A group of eye diseases involving characteristic optic-nerve damage, often associated with elevated intraocular pressure. Acetazolamide can lower intraocular pressure by reducing aqueous humor formation.
Drug metabolism: The chemical modification of drugs by the body, affecting their activity and elimination. Acetazolamide is largely excreted unchanged, so renal function strongly influences exposure.
Methazolamide: An oral carbonic anhydrase inhibitor used chiefly to lower intraocular pressure. It is a related systemic alternative for glaucoma, with different pharmacokinetic properties.
Sulfanilamide: An antibacterial sulfonamide drug introduced in the 1930s and a precursor to many sulfonamide compounds. Research on sulfonamide effects led investigators to identify carbonic anhydrase inhibition.
Renal bicarbonate handling: The kidney processes that reabsorb filtered bicarbonate and regulate its excretion in urine. Inhibiting renal carbonic anhydrase increases bicarbonate loss, producing alkaline urine and metabolic acidosis.
Acute mountain sickness: A syndrome of headache and other symptoms that can develop after rapid ascent to high altitude. Acetazolamide speeds acclimatization by promoting ventilation and correcting altitude-related respiratory changes.
Renal clearance: The volume of plasma cleared of a substance by the kidneys per unit time. Impaired kidney function can increase acetazolamide exposure and complicate its use.
Dorzolamide: A topical carbonic anhydrase inhibitor used to reduce intraocular pressure. Unlike acetazolamide, it is applied to the eye and generally has fewer systemic effects.
Robert DeCasperis: An American medicinal chemist associated with the development of acetazolamide at Lederle Laboratories. His work contributed to turning carbonic anhydrase inhibition into a therapeutic drug strategy.

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