Of the numerous drugs that have been introduced into clinical medicine within the last three years, the substance acetazolamide (Diamox)1 is unique in a number of ways. This substance, a heterocyclic sulfonamide, acts as a diuretic because of its property of inhibiting the enzyme carbonic anhydrase. By exerting its action in the kidney tubule, acetazolamide blocks rapid equilibration between tubular sodium bicarbonate and intracellular hydrogen ion, preventing acidification of the urine and allowing excretion of sodium bicarbonate together with large quantities of water. Due to a yet unknown mechanism,2 the secretion of aqueous humor is also inhibited by acetazolamide, and the drug has found widespread use in combating glaucoma. Reports have been uniformly favorable on the relative mildness of and infrequency of side-effects from the drug, even when administered over long periods of time. Urologic complications have been virtually negligible. In a series of cases reported by Becker,
Persky L, Chambers D, Potts A. CALCULUS FORMATION AND URETERAL COLIC FOLLOWING ACETAZOLAMIDE (DIAMOX) THERAPY. JAMA. 1956;161(17):1625–1626. doi:10.1001/jama.1956.62970170001005
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