diuretic drug medication

Hydrochlorothiazide ( HCTZ or HCT ) is a diuretic drug medicine often used to treat high lineage blackmail and swelling due to fluid build up. [ 3 ] other uses include treating diabetes insipidus and nephritic tubular acidosis and to decrease the risk of kidney stones in those with a high calcium level in the urine. [ 3 ] Hydrochlorothiazide is less effective than chlortalidone for prevention of heart attack or stroke. [ 4 ] [ 3 ] [ 5 ] HCTZ is taken by talk and may be combined with other lineage atmospheric pressure medications as a one pill to increase potency. [ 3 ] likely side effects include poor people kidney function ; electrolyte imbalances, including low blood potassium, and, less normally, low blood sodium, gout, high blood sugar, and feeling lightheaded with standing. [ 3 ] While allergies to HCTZ are reported to occur more frequently in those with allergies to sulfa drugs, this association is not well supported. [ 3 ] It may be used during pregnancy, but it is not a first-line medicine in this group. [ 3 ]

It is in the thiazide medicine class and acts by decreasing the kidneys ‘ ability to retain water. [ 3 ] This initially reduces lineage volume, decreasing lineage return key to the heart and frankincense cardiac output. [ 6 ] It is believed to lower peripheral vascular resistor in the long run. [ 6 ] Two companies, Merck and Ciba, state of matter they discovered the medicine which became commercially available in 1959. [ 7 ] It is on the World Health Organization ‘s List of Essential Medicines. [ 8 ] It is available as a generic drug [ 3 ] and is relatively low-cost. [ 9 ] In 2019, it was the eleventh most normally order medicine in the United States, with more than 38 million prescriptions. [ 10 ] [ 11 ]

medical uses [edit ]

Hydrochlorothiazide is frequently used for the treatment of high blood pressure, congestive heart failure, diagnostic edema, diabetes insipidus, nephritic tubular acidosis. [ 3 ] It is besides used for the prevention of kidney stones in those who have high levels of calcium in their urine. [ 3 ] Hydrochlorothiazide is recommended as an appropriate option for initial monotherapy in patients with meek primary high blood pressure. [ 12 ] [ 13 ] A taxonomic, multinational, large-scale analysis by Suchard et aluminum. supported comparison between drug classes for initiating monotherapy in high blood pressure, however thiazide or thiazide-like diuretics showed better primary potency and safety profiles than angiotensin-converting enzyme inhibitors and non-dihydropyridine calcium channel blockers. [ 12 ] Hydrochlorothiazide is less potent but not inevitably less effective than chlorthalidone in reducing blood coerce. [ 14 ] [ 15 ] More robust studies are required to confirm which drug is superior in reducing cardiovascular events. [ 16 ] Side impression profile for both drugs appear alike and are dose dependent. [ 14 ] [ 15 ] [ 16 ] Hydrochlorothiazide is besides sometimes used to prevent osteopenia and for treatment of hypoparathyroidism, [ 17 ] hypercalciuria, Dent ‘s disease, and Ménière ‘s disease. For diabetes insipidus, the effect of thiazide diuretics is presumably mediated by a hypovolemia-induced increase in proximal sodium and urine resorption, thereby diminishing water delivery to the ADH-sensitive sites in the gather tubules and increasing the urine osmolality. [ medical citation needed ] A low level of attest, predominately from experimental studies, suggests that thiazide diuretics have a modest beneficial impression on bone mineral concentration and are associated with a decreased fracture risk when compared with patients not taking thiazides. [ 18 ] [ 19 ] [ 20 ] Thiazides decrease mineral bone loss by promoting calcium retentiveness in the kidney, and by directly stimulating osteoblast differentiation and bone mineral formation. [ 21 ] It may be given together with early antihypertensive agents in fixed-dose combination preparations, such as in losartan/hydrochlorothiazide ( see below ). [ medical citation needed ]

adverse effects [edit ]

  • Hypokalemia, or low blood levels of potassium are an occasional side effect. It can be usually prevented by potassium supplements or by combining hydrochlorothiazide with a potassium-sparing diuretic
  • Other disturbances in the levels of serum electrolytes, including hypomagnesemia (low magnesium), hyponatremia (low sodium), and hypercalcemia (high calcium)
  • Hyperuricemia (high levels of uric acid in the blood). All thiazide diuretics including hydrochlorothiazide can inhibit excretion of uric acid by the kidneys, thereby increasing serum concentrations of uric acid.This may increase the incidence of gout in doses of ≥ 25mg per day and in more susceptible patients such as male gender of <60 years old.[22] [23][24]
  • Hyperglycemia, high blood sugar
  • Hyperlipidemia, high cholesterol and triglycerides
  • Headache
  • Nausea/vomiting
  • Photosensitivity
  • Weight gain
  • Pancreatitis

The frequency of side effects increase as the medication dose is increased and the highest happening of side effects occur at doses greater than 25 magnesium per day. [ medical citation needed ] box inserts contain dim and discrepant data surrounding the practice of thiazide diuretics in patients with allergies to sulfa drugs, with little evidence to support these statements. [ 25 ] A retrospective age group learn conducted by Strom et aluminum. concluded that there is an increased hazard of an allergic reaction occurring in patients with a predisposition to allergic reactions in general preferably than cross reactivity from structural components of the sulfonamide-based drug. [ 26 ] Prescribers should examine the evidence cautiously and ass each affected role individually, paying particular attention to their anterior history of sulfa drug hypersensitivity quite than relying on drug monograph information. [ 27 ]

There is an increase risk of non-melanoma skin cancer. [ 28 ] In August 2020, the australian Therapeutic Goods Administration required the Product Information ( PI ) and Consumer Medicine Information ( CMI ) for medicines containing hydrochlorothiazide to be updated to include details about an increase gamble of non-melanoma skin cancer. [ 29 ] In August 2020, the U.S. Food and Drug Administration ( FDA ) updated the drug label about an increase hazard of non-melanoma bark cancer ( basal cell skin cancer or squamous cell skin cancer ). [ 30 ]

mechanism of action [edit ]

Hydrochlorothiazide belongs to thiazide class of diuretics. It reduces blood volume by acting on the kidneys to reduce sodium ( Na+ ) resorption in the distal convoluted tubule. The major site of carry through in the nephron appears on an neutral NaCl co-transporter by competing for the chloride web site on the conveyer belt. By impairing Na+ transportation in the distal convoluted tubule, hydrochlorothiazide induces a natriuresis and attendant urine loss. Thiazides increase the resorption of calcium in this segment in a manner unrelated to sodium transport. [ 31 ] Additionally, by early mechanisms, HCTZ is believed to lower peripheral vascular resistance. [ 6 ]

dose [edit ]

In a double-blind, randomized study, the effects of 25 mg/day vs. 50 mg/day of hydrochlorothiazide were evaluated in geriatric patients ( n = 51 ) with detached systolic high blood pressure. Both dosages were associated with like reductions in blood pressure ; however, the higher drug ( 50 mg/day ) caused a greater decline in serum potassium concentration. [ 32 ] For this reason 12.5 mg/day is most frequently initiated for the antihypertensive effects .

company and culture [edit ]

Two generic benazepril HCl 20 milligram and HCTZ 25 milligram oral tablets

Trade names [edit ]

Hydrochlorothiazide is available as a generic drug under a large number of brand names, including Apo-Hydro, Aquazide, BPZide, Dichlotride, Esidrex, Hydrochlorot, Hydrodiuril, HydroSaluric, Hypothiazid, Microzide, Oretic and many others. [ medical citation needed ] To reduce pill burden and in club to reduce side effects, hydrochlorothiazide is often used in fixed-dose combinations with many early classes of antihypertensive drugs such as :

sport [edit ]

Use of hydrochlorothiazide is prohibited by the World Anti-Doping Agency for its ability to mask the manipulation of performance-enhancing drugs. [ 34 ]

See besides [edit ]

References [edit ]

  • “Hydrochlorothiazide”. Drug Information Portal. U.S. National Library of Medicine.