Abstract
Acetazolamide inhibits carbonic anhydrase and is clinically used in the treatment of glaucoma and epilepsy in children instead of diuretic agents. We experienced two patients with chronic renal failure who became somnolent a few days after oral administration of acetazolamide. Patient 1 was 62-year-old man with a two-year history of hemodialysis. He became somnolent 3 days after daily administration of acetazolamide (0.5g/day) for the treatment of an episode of glaucoma. Patient 2 was a 54-year-old man with chronic renal failure due to diabetic nephropathy. Somnolence followed 3 days of administration of acetazolamide (0.75g/day). In both cases normal consciousness returned soon after the discontinuation of acetazolamide. The electroencephalograms of both were compatible with metabolic encephalopathy. Based on these findings, we believe that accumulation of acetazolamide because of failure to be excretion by chronic renal failure patients in turn causing cerebral metabolic acidosis was responsible for the consciousness disorder.
