If CA activity is inhibited, HCO 3 - reabsorption is reduced and exits the proximal tubule in much larger amounts. CA inhibitors are relatively weak. Because ocular fluid and CSF production is dependent on CA, inhibitors can be used to treat glaucoma or increased CNS pressure. Because this is the same site responsible for concentrating and diluting urine, loop diuretics decrease maximal urinary concentrating and diluting. They are rapidly absorbed from the gut and can be given i.v.
Loops can also inhibit release of insulin.
CHF, renal insufficiency, and nephrotic syndrome. Also useful for correcting hypercalcemia. Use with caution is pts that are likely to be susceptible to volume contraction from excessive diuresis, i.e. hypertension treatment in elderly with little or no edema. Caution in pts susceptible to hypokalemia, i.e. digitalis administration, hepatic cirrhosis. These compounds then are relatively ineffective in renal insufficiency .