Why acetazolamide contraindicated in cirrhosis?

Acetazolamide is contraindicated in cirrhosis due to the risk of hepatic encephalopathy.

Acetazolamide is a carbonic anhydrase inhibitor that is used to treat a variety of conditions, including glaucoma, altitude sickness, and epilepsy. It works by inhibiting the enzyme carbonic anhydrase, which leads to a decrease in the production of bicarbonate ions. This can cause a reduction in the pH of the blood, which can lead to hepatic encephalopathy in patients with cirrhosis.

Hepatic encephalopathy is a condition that occurs when the liver is unable to properly remove toxins from the blood. This can lead to a variety of symptoms, including confusion, drowsiness, tremors, and seizures. In severe cases, hepatic encephalopathy can be fatal.

The risk of hepatic encephalopathy is increased in patients with cirrhosis because they have a reduced ability to clear toxins from the blood. Acetazolamide can further reduce the ability of the liver to clear toxins, which can lead to hepatic encephalopathy.

For these reasons, acetazolamide is contraindicated in patients with cirrhosis.