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November 1967

Potassium, Acetazolamide, and Intraocular Pressure

Author Affiliations

Bethesda, Md
From the Ophthalmology Branch, National Institute of Neurological Diseases and Blindness, National Institutes of Health, Public Health Service, US Department of Health, Education, and Welfare, Bethesda, Md. Dr. Spaeth is presently affiliated with Wills Eye Hospital and the University of Pennsylvania, Philadelphia.

Arch Ophthalmol. 1967;78(5):578-582. doi:10.1001/archopht.1967.00980030580003

The effect of long-term administration of acetazolamide on the potassium balance of 15 glaucoma patients was studied. Average duration of treatment was two years. No total body potassium depletion was noted; serum potassium was below normal in one case (3.1 mEq/liter). Administration of potassium chloride (average dose, 58 mEq daily) did not cause a lowering of intraocular pressure; nor did it appear to alter potassium balance. Patients receiving long-term treatment with acetazolamide were unable to excrete concentrated urine (serum osmolarity per urine osmolarity ratio of 1:2.3 after an 18-hour fast). Three of 15 patients developed urinary tract disease. Patients on long-term acetazolamide therapy rarely need supplemental potassium. Where advisable, it is best provided by a diet high in potassium-rich foods, as enteric-coated preparations may cause small-bowel ulceration.

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