[Efficacy of acetazolamide treatment of patients with hypercapnia and superimposed metabolic alkalosis]. / Eficacia del tratamiento con acetazolamida en pacientes con hipercapnia y alcalosis metabólica sobreimpuesta.
Rev Clin Esp
; 197(4): 237-40, 1997 Apr.
Article
em Es
| MEDLINE
| ID: mdl-9254398
ABSTRACT
BACKGROUND:
Metabolic alkalosis usually complicates the evolution of patients with hypercapnia under diuretic or steroid therapy. The objective of this study was to analyze the efficiency of therapy with acetazolamide, a reversible carbonic anhydrase inhibitor, in this condition. PATIENTS ANDMETHODS:
Prospective study conducted at our hospital from June 1994 to March 1996, with 45 patients who had chronic respiratory acidosis and metabolic alkalosis. After a previous stabilization of the patient and eventually the discontinuation of diuretic or corticosteroid drugs fro 24-48 hours, 500 or 750 mg of acetazolamide were administered daily for 48 hours. Later, variations both in arterial gasometry and venous electrolytes were analyzed by comparing two means of paired data.RESULTS:
After therapy with acetazolamide a clinical improvement was observed in patients, a decrease in PaCO2, pH and CO3H (p < 0.001) and an increase in PaO2 (p < 0.001). Hypochloremia (82.2%) and hypopotassemia (33.3%) were the most common electrolytic abnormalities before therapy. Both abnormalities improved significantly after the administration of acetazolamide. In five patients (11.1%) acetazolamide was discontinued when metabolic acidosis appeared, which only in three cases was associated with acidemia. No secondary effects were observed.CONCLUSIONS:
Acetazolamide is an efficient alternative for treatment of patients with respiratory acidosis and metabolic alkalosis, particularly when other more common measures in this condition (discontinuation of diuretics and/or volemic replacement) have failed or are contraindicated. On the other hand, the emergence of relevant secondary effects is unlikely.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Inibidores da Anidrase Carbônica
/
Alcalose
/
Hipercapnia
/
Acetazolamida
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
Es
Revista:
Rev Clin Esp
Assunto da revista:
MEDICINA
Ano de publicação:
1997
Tipo de documento:
Article