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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Acetazolamide treatment of hypokalemic periodic paralysis. Probable mechanism of action.

Following administration of glucose and insulin to three patients with hypokalemic periodic paralysis, serum K+ fell 1.9 mM. After administration of acetazolamide, 250 mg four times daily, serum K+ fell 0.9 mM, a substantial difference. In normal persons glucose and insulin lowered serum K+ 0.5 mM, and this was not changed substantially by acetazolamide. The metabolic acidosis induced by the drug appears to be responsible for the change in decrement of serum K+ and for the amelioration of symptoms in the patients. The findings agree with earlier reports that metabolic acidosis lowers the rate of entry of K+ into muscle, thus opposing the heightened or pathological entry of K+ into muscle cells during attacks of the disease.[1]


  1. Acetazolamide treatment of hypokalemic periodic paralysis. Probable mechanism of action. Vroom, F.W., Jarrell, M.A., Maren, T.H. Arch. Neurol. (1975) [Pubmed]
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