Site of Action
Diuretic Effects on Electrolytes
Osmotic diuretic. ↑ serum osmolality → fluid shift from interstitium to intravascular space → ↑ urine flow, ↓ intracranial/intraocular pressure
Use: Drug overdose, elevated intracranial/intraocular pressure, augmenting diuresis.
SE: Dehydration, hypo- or hypernatremia, pulmonary edema. Contraindicated in anuria, HF.
Carbonic anhydrase inhibitor. Causes self-limited NaHCO3 diuresis and ↓ total body HCO3− stores. Alkalinizes urine.
Use: Glaucoma, metabolic alkalosis, altitude sickness (by offsetting respiratory alkalosis), idiopathic intracranial hypertension (pseudotumor cerebri).
SE: Proximal renal tubular acidosis (type 2 RTA), paresthesias, NH3 toxicity, sulfa allergy, hypokalemia. Promotes calcium phosphate stones (insoluble at high urine pH).
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“Acid”azolamide causes acidosis.
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