To treat metabolic alkalosis, which medication would be appropriate?

Acetazolamide is appropriate for treating metabolic alkalosis because it is a carbonic anhydrase inhibitor that promotes the excretion of bicarbonate in the urine. This mechanism can help to decrease bicarbonate levels in the blood, effectively correcting metabolic alkalosis. By inhibiting the enzyme, acetazolamide reduces the reabsorption of bicarbonate in the renal tubules, facilitating its elimination and thus lowering the alkalotic state.

In contrast, amiloride is a potassium-sparing diuretic primarily used to treat hypertension or heart failure; it does not have a role in managing metabolic alkalosis. Hydrochlorothiazide, a thiazide diuretic, can actually exacerbate metabolic alkalosis due to its action on electrolyte reabsorption, leading to increased bicarbonate levels. Mannitol, an osmotic diuretic, is used to treat conditions like increased intracranial pressure and does not specifically address the underlying issues of metabolic alkalosis. Therefore, acetazolamide is the most suitable choice for this condition.