By which of the following mechanisms does acetazolamide alter a patient's serum pH?
a. Increasing the blood pH and lowering the urine pH
b. Decreasing the blood pH and raising the urine pH
c. Increasing both the blood and the urine pH
d. Lowering both the blood and the urine pH
ANS: B
Acetazolamide, a carbonic anhydrase inhibitor, raises urinary pH by increasing the urinary loss of HCO3- but paradoxically lowers blood pH by promoting the elimination of Na+, K+, bicarbonate, and H2O.
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