What is the mechanism of action of acetazolamide?

Acetazolamide functions through its role as a carbonic anhydrase inhibitor. Carbonic anhydrase is an enzyme that catalyzes the reversible reaction involving carbon dioxide and water, which produces carbonic acid. This enzyme is crucial in various physiological processes, including the regulation of acid-base balance and facilitating the reabsorption of bicarbonate, particularly in the kidneys.

By inhibiting carbonic anhydrase, acetazolamide decreases the reabsorption of bicarbonate in the renal tubules, leading to increased bicarbonate and consequently increased sodium and water excretion. This mechanism results in a mild diuretic effect. Additionally, acetazolamide’s inhibition of carbonic anhydrase can also lead to metabolic acidosis, as it reduces the availability of bicarbonate in the body, which can be beneficial in conditions like altitude sickness, where the body is trying to compensate for lower oxygen levels.

The other mechanisms mentioned in the alternatives refer to different classes of pharmacological agents. Alpha-adrenergic agonists engage in activating alpha-adrenergic receptors, while beta-blockers work on beta-adrenergic receptors, and calcium channel blockers prevent calcium influx into cells. None of these mechanisms apply to the way acetazolamide operates,