Refer Chlorthiazide- Thiazide and related diuretics

Cross allergy and inhibition of thiazides, sulphonamide antibiotics and sulphonylurea. Hypoglycaemia may occur.

Potententiates bone marrow suppression caused by anticancer drugs.

Diuretic induced volume depletion can potentiate aminoglycoside nephrotoxicity. Impairs action of oral hypoglycaemic agents.

Enhances digitalis toxicity due to hypokalaemia Volume depletion enhances lithium toxicity, conversely sudden stoppage of diuretics may result in subtherapeutic levels of circulating lithium.

Prolonged paralysis due to tubocuraine.

NASID antagonise hypotensive action.

Suppress action of oral anticoagulants due to reduced prothrombin activity.

Increased risks of hypokalaemia when corticosteroids given concurrently.

Edema and hypertension

Thiazides and related diuretics include- Bendroflumethiazide, Benzthiazide, Chlorthiazide, Hydrochlorthiazide, Hydroflumethazide, Indapamide, Methyclothizide, Metolazone, Polythiazide, Quinethazone, Trichlormethiazide

Refer Hydrochlorthiazide- Thiazide and related diuretics

Rare severe hyponatraemia and idiosyncratic hypersentivity.

Dry mouth, fatigue, muscle cramps and nausea.

Diabetes and gout may be precipitated. Impotence, raised blood levels of glucose, urate, lipids and calcium.

Reduced levels of potassium and magnesium.

Raised CPK levels.

Anuria,pregnancy & lactation,asthma,hypersens.

Contraindications:

Renal/liver disease, diabetes, gout, hyperlipidermia and ventricular extra systoles.

Indications:

Edema, hypertension.

Dosage:

Edema- Initiate therapy with 50 to 100mg daily, or 100mg on alternate days.

Hypertension- initiate therapy with 25mg/day.

Hyperuricemia

Asymptomatic hyperurecemia is that stage in which the serum urate is raised but arthiritic symptoms , tophi, or uric acid stones have not appeared.

The phase of asymptomatic hyperuricemia ends with the first attack of gouty arthiritis or nephrolithiasis . In most cases gout comes before stones usually after at least 20 to 30 years of sustained hyperuricemia.

Drugs Causing adverse reactions-

1. Thiazides

2. Chlorthalidone

3. Ethacrynic acid

4. Thiazides

5. Furosemide

6. Diazoxide

7. Growth hormone

Thiazide diuretics

1. May cause GI upset, may be taken with food

2. Drug will initially increase urination which should subside after a few weeks, take early during the day or as directed

3. Notify physician, if muscle pain,weakneess or cramps, nausea, vomiting, restlessness, excess thirst, tiredness, drowsiness, increased heart rate or pulse, diarrhea, or dizziness occurs

4. May cause photosensitivity (sensitivity to sunlight). Avoid prologed exposure to the sun and other ultraviolet light. Use sunscreens and wear protective clothing until tolerance is determined

5. May increase blood sugar levels in diabetes

6. Do not drink alcohol or take other medications without physicians approval, this includes nonprescription medicines for appetite control, asthma, colds, cough,hay fever or sinus

7. Do not interrupt , discontinue or adjust the dose, even if feeling well. Follow physicians instruction regarding missed dose.

Thiazides and related diuretics include-

Bendroflumethiazide, Benzthiazide, Chlorthiazide, Hydrochlorthiazide, Hydroflumethazide, Indapamide, Methyclothizide, Metolazone, Polythiazide, Quinethazone, Trichlormethiazide

Refer Hydrochlorthiazide- Thiazide and related diuretics 

Take during meals
 

Contraindicated for use during pregnancy and lactation.

Observe caution.