Clorothiazid Diuretics And Precautions For Use

Clorothiazide and thiazide diuretics are among the drugs used to treat hypertension (used alone or in combination with other blood pressure medications such as angiotensin converting enzyme inhibitors (ACE-1) or blockers beta).
The drug has the effect of increasing the excretion of sodium chloride and water due to the mechanism of inhibiting the reabsorption of Na + and Cl- ions at the tip of the distal tubule. The diuretic effect of thiazides is moderate because nearly 90% of the amount of the kidney filter is reabsorbed, before reaching the distal tubule where the effects of these drugs are. The antihypertensive effect of the drug, primarily due to the decrease in plasma volume and extracellular fluid involved in sodium urinary excretion, is a very short process.
Thereafter, during the drug administration, the antihypertensive effect depends on the decrease in peripheral resistance, through the gradual adaptation of blood vessels to the decrease in Na + concentration

. So the antihypertensive effect of thiazides appears slowly after 1-2 weeks, but the diuretic effect appears quickly after a few hours.
In addition, the drug is also used in cases of: edema due to heart failure, edema due to other etiologies (liver, kidney), corticosteroids, estrogen; diabetes insipidus. To treat acute pulmonary edema, furosemide is a potent diuretic of choice, not thiazides
After drinking, the drug absorbed relatively quickly.



However, thiazides in general and chlorothiazides in particular, have a poor diuretic effect in patients with renal insufficiency. There is no familiar phenomenon when used long term. The treatment guidelines emphasize that the lowest and optimal dose will reduce the risk of adverse effects.
When used to treat hypertension, it is important to wait for sufficient time to assess the body's response to chlorothiazide antihypertensive effects because the effect on peripheral resistance takes time. to show clearly. Do not use the drug in cases of liver failure, kidney failure (anuria), manifestations of gout, hypersensitivity to thiazides and sulfonamid derivatives.
All patients using chlorothiazide must be monitored periodically electrolytes in serum and urine (Na, Cl, K, Ca, Mg) especially corticosteroid users, ACTH, digitalis, quinidine
Gout (aggravating disease), diabetes (pay attention to adjust insulin, hypoglycemic drugs .



.. because chlorothiazide can cause hyperglycemia) ...
When using chlorothiazid can cause a lot of potassium loss. This effect depends on the dose. Using a low dose of 125mg / day is usually the right dose for anti-hypertensive treatment, reducing the risk of excessive potassium loss as well as reducing the risk of hyperuricemia and reducing the risk of adverse effects in glucid metabolism.




These undesirable effects are common in patients with impaired liver function, severe heart failure and the elderly. To overcome this side effect, it is important to provide adequate potassium in your daily diet or supplement with medication (as directed by a physician)..

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