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Acetazolamide Metabolic Acidosis Mechanism

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This lesson explores how sodium is regulated along the thick ascending limb (TAL). In particular, the role of the sodium, potassium, 2 chloride cotransporter (NKCC2), the sodium/hydrogen exchanger (NHE3), the paracellular pathway, driving forces, and how genetic mutations and loop diuretics affect sodium reabsorption. For help preparing for an exam on this and other topics, visit http://www.aniveo.com

Acetazolamide - Ascending Limb - Barnard Health Care

The diuretic which is most commonly associated with the development of metabolic acidosis is acetazolamide. This diuretic acts by inhibiting the enzyme carbonic anhydrase. Given the central role that this enzyme plays in bicarbonate reabsorption in the proximal tubule, administration of this diuretic leads to the development of metabolic acidosis by disrupting the process of bicarbonate reclamation. The mechanism by which acetazolamide leads to inhibition of bicarbonate reabsorption is directly related to its ability to inhibit luminal carbonic anhydrase. This enzyme normally catalyzes the dehydration of carbonic acid (produced when filtered bicarbonate reacts with secreted hydrogen ions) to water and C02, thereby maintaining a favorable concentration gradient for further hydrogen ion secretion. The uncatalyzed dehydration of carbonic acid occurs very slowly. By inhibiting the activity of this enzyme, acetazolamide allows for the concentration of luminal carbonic acid to increase. The resultant increase in hydrogen ion concentration creates an unfavorable concentration gradient for further hydrogen ion secretion. Due to the lipid solubility of acetazolamide, inhibition of intracel Continue reading >>

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  1. RASHMILA123

    moinsiddique
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    Because the carbonyl group in a ketone must be attached to two carbon groups, the simplest ketone has three carbon atoms. It is widely known as acetone, a unique name unrelated to other common names for ketones.


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    How to learn science easily

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    Why do human beings not respire through diffusion? (class 10 CBSE SAMPLE PAPER 2017-18 SCIENCE)

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Basic home exercise plan for seniors or individuals living with chronic disease such as cardiovascular disease, diabetes, COPD and metabolic disease. The exercises were performed by Nick Pratap who is a ACSM Certified Clinical Exercise Physiologist and Kinesiologist who prescribes exercise to patients who have chronic disease. Website: www.nextgenrehab.ca

Use Of Acetazolamide In Copd Patients

I'm a doctor in Ho Chi Minh City, Vietnam. In my department (Pulmonology), some doctors prescribe acetazolamide for the patients with COPD who have edema and chronic respiratory failure. What is the role of acetazolamide in these patients? Response from Christine Campbell Reardon, MD Some patients with chronic obstructive pulmonary disease (COPD) develop carbon dioxide (CO2) retention and hypoxemia. There are multiple factors that lead to the development of CO2 retention. One of the major factors is an alteration of ventilation and perfusion matching leading to an increase in dead space. The diaphragm may function at an anatomical disadvantage in patients with COPD. In the setting of hyperinflation caused by airflow obstruction, the diaphragm is flattened and generates less pressure than what would occur under normal circumstances. In addition, hypercapnic patients demonstrate a breathing pattern characterized by a lower tidal volume and higher respiratory rate, which increases dead space. The lower tidal volume is caused by a shorter inspiratory time rather than a decrease in respiratory drive. It had previously been thought that hypercapnic COPD patients had a blunted central re Continue reading >>

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  1. LWYZYKOWSKI

    I find that testing at night my sticks are much darker. I also read in ATkins to test later in the day. Often in the AM the sticks are the lightest for me.
    However, I dont understand how my sticks are turning, butI dont seem to be losing very fast. It might be just water retention.. I hope!

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  2. XANADUREALM

    Gigi, thanks for the valuable info on Ketosis.
    Everyone should consider several things before giving up drinking the water. First, test first thing in the morning before eating or drinking anything. Second, give up all artificial sweetners or things with them it it. If you are still not in ketosis after a few days, then look at what carbs you have been consuming. Maybe you are one of those people who are very carb sensitive. Try a couple of day with meat, eggs and green veggies.
    As the article says make sure your sticks are fresh.
    The Waist Management Team
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  3. GIGIX068

    I was under the understanding that the ketostix will not measure accurately when we drink a lot of water. Your urine is too diluted to get a good result. I test in the morning.
    Here is a copy and paste with a lot more information than you asked for--but it might be helpful. After I read it I understood that because of the volume of water I drink that it is not registering but I am still in ketosis.
    What are ketones?
    Ketones are a normal and efficient source of fuel and energy for the human body. They are produced by the liver from fatty acids, which result from the breakdown of body fat in response to the absence of glucose/sugar. In a ketogenic diet, such as Atkins ... or diets used for treating epilepsy in children, the tiny amounts of glucose required for some select functions can be met by consuming a minimum amount of carbs - or can be manufactured in the liver from PROTEIN. When your body is producing ketones, and using them for fuel, this is called "ketosis".
    How will ketosis help me to lose weight?
    Most reducing diets restrict calorie intake, so you lose weight but some of that is fat and some of it is lean muscle tissue as well. Less muscle means slowed metabolism, which makes losing weight more difficult and gaining it back all too easy. Ketosis will help you to lose FAT.
    Being in ketosis means that your body's primary source of energy is fat (in the form of ketones). When you consume adequate protein as well, there's no need for the body to break down its muscle tissue. Ketosis also tends to accelerate fat loss --- once the liver converts fat to ketones, it can't be converted back to fat, and so is excreted.
    But, isn't ketosis dangerous?
    Being in ketosis by following a low carbohydrate diet is NOT dangerous. The human body was designed to use ketones very efficiently as fuel in the absence of glucose. However, the word ketosis is often confused with a similar word, ketoacidosis.
    Ketoacidosis is a dangerous condition for diabetics, and the main element is ACID not ketones. The blood pH becomes dangerously acidic because of an extremely high blood SUGAR level (the diabetic has no insulin, or doesn't respond to insulin .... so blood sugar rises ... ketones are produced by the body to provide the fuel necessary for life, since the cells can't use the sugar). It's the high blood sugar, and the acid condition that is so dangerous. Ketones just happen to be a part of the picture, and are a RESULT of the condition, not the CAUSE. Diabetics can safely follow a ketogenic diet to lose fat weight ... but they must be closely monitored by their health care provider, and blood sugars need to be kept low, and stable.
    How do the ketone test strips work, and where can I get them?
    Ketone urine-testing strips, also called Ketostix or just ketone sticks ... are small plastic strips that have a little absorptive pad on the end. This contains a special chemical that will change colour in the presence of ketones in the urine. The strips may change varying shades of pink to purple, or may not change colour at all. The container will have a scale on the label, with blocks of colour for you to compare the strip after a certain time lapse, usually 15 seconds. Most folks simply hold a strip in the flow of urine. Other folks argue that the force of the flow can "wash" some of the chemical away, and advise that a sample of urine be obtained in a cup or other container, then the strip dipped into it.
    The chemical reagent is very sensitive to moisture, including what's in the air. It's important to keep the lid of the container tightly closed at all times, except for when you're getting a strip to take a reading. Make sure your fingers are dry before you go digging in! They also have an expiry date, so make note of this when you purchase the strips ... that's for the UNopened package. Once opened, they have a shelf-life of about 6 months -- you may wish to write the date you opened on the label for future reference.
    Ketone test strips can be purchased at any pharmacy, and are usually kept with the diabetic supplies. In some stores they're kept behind the counter, so if you don't see them on the shelf, just ask the pharmacist; you don't need a prescription to buy them.
    I'm following Induction strictly; why won't my strips turn purple?
    Ketones will spill into the urine ONLY when there is more in the blood than is being used as fuel by the body at that particular moment.
    You may have exercised or worked a few hours previously, so your muscles would have used up the ketones as fuel, thus there will be no excess. You may have had a lot of liquids to drink, so the urine is more diluted. Perhaps the strips are not fresh, or the lid was not on tight and some moisture from the atmosphere got in.
    Some low carbers NEVER show above trace or negative even ... yet they burn fat and lose weight just fine. If you're losing weight, and your clothes are getting looser, you're feeling well and not hungry all the time .. then you are successfully in ketosis. Don't get hung up on the strips; they're just a guide, nothing more.
    Will I lose weight faster if the strips show dark purple all the time?
    No. Testing in the darkest purple range all the time is usually a sign of dehydration -- the urine is too concentrated. You need to drink more water to dilute it, and keep the kidneys flushed.
    The liver will make ketones from body fat, the fat you EAT, and from alcohol --- the ketone strips have no way of distinguishing the source of the ketones. So, if you test every day after dinner, and dinner usually contains a lot of fat, then you may very well test for large amounts of ketones all the time. However this does not indicate that any BODY fat was burned.
    The strips only indicate what's happening in the urine. Ketosis happens in the blood and body tissues. If you're showing even a small amount, then you are in ketosis, and fat-burning is taking place. Don't get hung up on the ketone sticks.
    Does caffeine affect ketosis?
    This is questionable. There ARE a few studies that suggest caffeine may cause blood sugar to rise, with consequent effect on insulin ... The studies involve consuming 50 gm glucose orally, followed by a dose of caffeine. This is quite different from a low carber, who is consuming only 20 gm carbs, in the form of high-fiber vegetables, spread throughout the day.
    Many low carbers continue to enjoy caffeine-containing beverages with no serious impact on their weight-loss efforts. However, there are some sensitive individuals ... and persons who are extremely insulin resistant may need to restrict or even eliminate all caffeine. If you have been losing successfully then find your weight loss stalled for a month or two, and you are following your program to the letter, you might consider stopping all caffeine for a while, to see if that will get things started again.
    Will drinking alcohol affect ketosis?
    No and yes. The liver can make ketones out of alcohol, so technically, when you drink you'll continue to produce ketones and so will remain in ketosis. The problem is ... alcohol converts more easily to ketones than fatty acids, so your liver will use the alchol first, in preference to fat. Thus, when you drink, basically your FAT burning is put on hold until all the alcohol is out of your system.
    This rapid breakdown of alcohol into ketones and acetaldehyde (the intoxicating by-product) ... tends to put low carbers at risk for quicker intoxication ... especially if no other food is consumed to slow absorption.
    RESOURCES
    Atkinscenter Official Website ... FAQ page, (select Ketosis)
    Ketosis ... from the Low Carb Diet and Exercise List
    Ketosis and Lipolysis ... from Low Carb Retreat
    I believe Gary Taubes!
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Nikita on Acute Mountain Sickness Presented at Parker Toastmasters Parker, Colorado http://www.parkertoastmasters.com

Mechanisms Of Action Of Acetazolamide In Prophylaxis And Treatment Of Acute Mountain Sickness

What are the 3 major classes of high altitude disease? 1)Acute mountain sickness (10% at 3500m, 75% at 4500) What are the multitude of systemic effects that make acteozolamide effective besides inducing metabolic acidosis (inducing chemoreceptors to respond more to hypoxic stimuli at high altitude? -Improvements in ventilation through, tissue respiratory acidosis -improvements in sleep quality from carotid body CA inhibition What are the two hypothesis that causes of AMS? ;What is the problem with these hypothesis?What is the agreement of symptoms caused by? 1) Hypoxia-mediated mild cerebral edema and increased cranial pressure; brain morphological changes don't correlate with symptoms of AMS 2)Vasogenic Edema: rupture of blood brain barrier, Free radical damage barrier function under hypoxic conditions don't support pathophysiology of AMS -HYPOXIA not hypobaria. Oxygen therapy also effective treatment Ambiguity of causes of AMS,but what is the relative agreement of symptoms? What txt is consistent with this? caused predominantly by hypoxia and not hypobaria --oxygen therapy is an effective treatment for AMS How did acetazolamide significantly increased minute ventilation by 50%? Continue reading >>

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  1. PROVERBS31JULIA

    I already have the PrecisionXtra made by Abbott. It will test both ketones and glucose - but not on the same strip!!
    You buy glucose strips separate and they are like other brands where you usually buy 50-100 at a time, and maybe a bit higher $$ than average glucose.
    Ketone strips are usually easier to buy online (EBay, Amazon, etc). They are usually 10 to a box and price runs $2-3 per strip - or cheaper maybe in Canada. They are a different foil pack color so you can either go by color or by the fact that glucose or Ketone are clearly printed on whichever one you are looking at. In addition, I have seen Ketone strips "cheaper" but they are closer to their expiration date. So you watch out for that.
    To my mind, the PrecisionXtra tests too high for glucose. Or else the old model I had (freestyle, also by Abbott, glucose only, a hand me down from my stepdad) was not working properly and read Low and/or I'm still in denial.
    What's that saying - there is no river in denial??
    So I have been going nuts trying to analyze the prices for the Nova Max Plus equipment, which from all appearances, will do the same as my PrecisionXtra but cheaper. Some will sell just the meter itself and I prolly don't need a new lancet specifically. EBay seems to have the cheapest just for the box of Ketone strips. So I may by the meter from Amazon or from the NovaMax website, and buy the strips from eBay. Or I may get the whiz-bang "free" meter with your choice of 2 box configurations - 2 boxes of ketone strips (total of 20 strips); 2 boxes of glucose (total 100 glucose strips); or 1 box Ketone (10) strips and 1 box of glucose (50) --- all three combos land at $39.98 or some such (and I am pretty much repeating what someone else said earlier here, or in another thread, sorry, more as confirming that I wasn't crazy since someone else had same info.)... thinking I may just do it that way, and then plan to buy replacement strips from the eBay vendors.
    Decisions decisions...
    Then I want to compare with the PrecisionXtra and see what my numbers are...
    Proverbs 31:17 She girds herself with strength,
    And strengthens her arms.


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  2. RITA1956

    What is the site to get it? It's a different meter than one a diabetic uses to check for glucose level right?
    Rita--Topsham,Maine--Eastern Time
    5% Weight Loss Challenge - Rowdy Rebels
    -You can find positive or negative in any situation depending on what you're looking for.
    -Nothing can taste as good as skinny and healthy is going to feel. *Psst, my version of skinny is me in size 12 jeans.

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  3. TRACY6659

    So I have questions about the blood testing for ketones. Are you using the standard diabetic testing supplies? The meter looks the same, but are there different types of test strips? or is it the same and there is a different reading you look for? obviously I'm confused
    * Tracy *
    Washington


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