Carbonic anhydrase inhibitor side effects. Serum chemical analysis
D. L. Epstein and W. M. Grant
Multiple serum chemical values were examined in 92 patients with chronic
glaucoma who were treated with the carbonic anhydrase inhibitors (CAIs)
acetazolamide or methazolamide, seeking relationships between serum
composition and symptomatic side effects. Of the 92 patients, 44 complained
of a symptom-complex of malaise, fatigue, weight loss, depression,
anorexia, and loss of libido, which we have found most commonly to threaten
continuation of therapy. Patients who had this symptom complex were
significantly more acidotic than those without it. Ten of 24 patients who
had chemical evidence of excessive acidosis reported a dramatic alleviation
of symptoms when sodium bicarbonate was administered, although their serum
CO2-combining power changed little. There was no correlation of the symptom
complex with serum potassium concentration, except in a few patients who
were simultaneously receiving chlorothiazide diuretics for systemic
hypertension and who became frankly hypokalemic.
