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It is derived from D-fructose and structurally related to acetazolamide. of carbonic anydrase (CA) and may result in hyperchloremic metabolic acidosis. heavy metals d) Carbon anhydrase inhibition: acetazolamide, sulfanylamide, mafenide. For this reason, it has also been called “mixed” renal tubular acidosis. by the presence of hyperchloremic and hypokalemic metabolic acidosis with. Renal Tubular Acidosis Dr. Simon Onsongo Objectives ‡ Review causes of. gap: ‡ q Bicarbonate, o chloride ‡ Hyperchloremic acidosis ‡ Renal vs. Multiple Myeloma ± Carbonic anhydrase inhibitors (Acetazolamide). hyperchloremic metabolic acidosis (HCMA) and metabolic acidosis. Acetazolamide-mediated decrease in strong ion difference accounts. aciclovir para el molusco contagioso El envenenamiento del glicol de etileno causa acidosis metabólica con un boquete. en coma, con una acidosis normal hyperchloremic del boquete del anión. por terapia combinada con los eyedrops del acetazolamide y del timolol. 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