Acetazolamide is a potent inhibitor of carbonic anhydrase, which results in wasting of sodium and bicarbonate in the proximal tubule, which results diuresis and also alkalinizes the urine.
Lab finding with chronic use (i.e. for glaucoma treatment):
- Metabolic acidosis due to decreased H+ secretion into the proximal tubule, and increased bicarbonate excretion into the tubule
- Hyponatremia due to sodium excretion
- Hypokalemia due to sodium potassium exchange
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