Acetazolamide treatment of hypokalemic periodic paralysis. Probable mechanism of action.
Following administration of glucose and insulin to three patients with hypokalemic periodic paralysis, serum K+ fell 1.9 mM. After administration of acetazolamide, 250 mg four times daily, serum K+ fell 0.9 mM, a substantial difference. In normal persons glucose and insulin lowered serum K+ 0.5 mM, and this was not changed substantially by acetazolamide. The metabolic acidosis induced by the drug appears to be responsible for the change in decrement of serum K+ and for the amelioration of symptoms in the patients. The findings agree with earlier reports that metabolic acidosis lowers the rate of entry of K+ into muscle, thus opposing the heightened or pathological entry of K+ into muscle cells during attacks of the disease.
D000086:Acetazolamide / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D000138:Acidosis / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002245:Carbon Dioxide / Q000097:blood; D004912:Erythrocytes / Q000032:analysis; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007008:Hypokalemia / Q000188:drug therapy*; D007328:Insulin / Q000494:pharmacology; D008297:Male; D010245:Paralyses, Familial Periodic / Q000188:drug therapy*; D011188:Potassium / Q000097:blood / Q000378:metabolism; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D002245:Carbon Dioxide; D005947:Glucose; D000086:Acetazolamide; D011188:Potassium