What medication, when taken with acetazolamide (Diamox), may require the nurse to contact the physician?

When acetazolamide (Diamox) is administered, it can potentially influence the clearance of lithium from the body. Acetazolamide is a carbonic anhydrase inhibitor that can induce metabolic acidosis, which may affect the renal handling of lithium. Lithium toxicity is a significant concern since the therapeutic range is narrow. As acetazolamide can increase lithium levels by reducing its excretion, monitoring lithium levels closely is crucial. If there’s a concern for elevated lithium levels that could lead to toxicity, it may prompt the nurse to contact the physician to adjust the lithium dosage or consider alternative therapies.

In contrast, medications such as ibuprofen, metformin, and warfarin do not exhibit the same degree of interaction with acetazolamide that necessitates immediate clinical oversight. While it’s important to be aware of potential risks with all medications, the specific interaction between acetazolamide and lithium is well-documented, thereby warranting additional attention from healthcare providers.