A 45-year-old woman with idiopathic intracranial hypertension is started on acetazolamide. Two weeks later she presents with fatigue and mild paresthesias. Vital signs show BP 128/82, HR 88, RR 16, temperature 37°C, SpO2 98%. Laboratory studies reveal bicarbonate 18 mEq/L, serum potassium 3.2 mEq/L, and normal anion gap. Chest X-ray shows no acute cardiopulmonary process. Which acid-base abnormality is most likely developing with this therapy?
- A)Respiratory alkalosis
- B)Anion gap metabolic acidosis
- C)Metabolic alkalosis
- D)Respiratory acidosis
- E)Nonanion gap metabolic acidosisGABARITO
Explicação
Acetazolamide inhibits carbonic anhydrase in the proximal tubule, reducing bicarbonate reabsorption and causing a hyperchloremic nonanion gap metabolic acidosis. This predictable adverse effect explains the fall in serum bicarbonate after therapy begins. Ver explicação completa e trilha adaptativa →