Final answer:
Acetazolamide is a carbonic anhydrase inhibitor diuretic that increases urinary excretion of bicarbonate, potentially leading to hypochloremic alkalosis. It is not a potassium-sparing diuretic and can indeed cause hypokalemia. The precise effect on bicarbonate reabsorption varies, and a safe dose will not completely abolish bicarbonate reabsorption. The correct answer to the student's question is D, as acetazolamide causes hypochloremic metabolic alkalosis.
Step-by-step explanation:
Acetazolamide is a diuretic medication that inhibits the enzyme carbonic anhydrase. By inhibiting this enzyme, acetazolamide reduces the reabsorption of bicarbonate ions, leading to increased urinary excretion of bicarbonate, sodium, water, and potassium. This results in an increased urine pH and diuresis (increased urine production). However, acetazolamide is not a potassium-sparing diuretic; instead, it can cause hypokalemia (decreased blood potassium levels). Acetazolamide may lead to a side effect known as a hypochloremic alkalosis, which is an imbalance in the body's acid-base balance due to excessive loss of chloride ions and retention of bicarbonate ions.
Regarding the options presented in the student's question:
- A is incorrect as the maximum increase in urine pH can occur at variable times post-administration.
- B is incorrect since a safe dose of acetazolamide does not result in a complete absence of bicarbonate reabsorption.
- C could be misleading, there isn't a specified percentage that represents the reduction in bicarbonate reabsorption for the maximum safe dose.
- D is correct - the use of acetazolamide can cause hypochloremic metabolic alkalosis.
- E is incorrect because acetazolamide is not a potassium-sparing diuretic; it can actually increase potassium excretion.
Use of acetazolamide should always be under medical supervision due to the potential for altering the body's electrolyte and acid-base balance.