Hydrochlorothiazide

Question 1

Trade name

Answer 1

Hydro-Par, Microzide

Question 2

Generic name

Answer 2

Hydrochlorothiazide

Question 3

Class of drug

Answer 3

Diuretic, antihyper-
tensive

Question 4

Usual dosage

Answer 4

PO (Adults): 12.5-100 mg/day in 1-2 doses (up to 200 mg/day; not to exceed 50 mg/day for hypertension; doses above 25 mg are associated with greater likelihood of electrolyte abnormalities).
PO (Children >6 mo): 2 mg/kg in 2 divided doses (not to exceed 200 mg/day).
PO (Children <6 mo): Up to 2-4 mg/kg/day in 2 divided doses (not to exceed 37.5 mg/day).

Question 5

How administered

Answer 5

Po

Question 6

Adverse effects

Answer 6

CV: hypotension. Derm: photosensitivity, rash, SKIN CANCER (nonmelanoma), STEVENS JOHNSON SYNDROME. EENT: acute angle-closure glaucoma, acute myopia. Endo: hyperglycemia. F and E: hypokalemia, dehydration, hypercalcemia, hypochloremic alkalosis, hypomagnesemia, hyponatremia, hypophosphatemia, hypovolemia. Gl: anorexia, cramping, hepatitis, nausea, PANCREATITIS, vomiting. Hemat: blood dyscrasias. Metab: hyperuricemia, hypercholesterolemia. MS: muscle cramps. Neuro: dizziness, drowsiness, lethargy, weakness.

Question 7

CONTRAINDICATIONS/PRECAUTIONS

Answer 7

Contraindicated in: Hypersensitivity (cross-sensitivity with other thiazides or sulfonamides may exist); Some products contain tartrazine and should be avoided in patients with known intolerance; Anuria( You don’t make any urine ), Lactation.
Use Cautiously in: Renal impairment (kidney problems) ; Hepatic impairment (liver problems) ; OB: Safety not established in pregnancy; Geri: Appears on Beers list (a list of medicines that can be risky for seniors). May worsen or cause hyponatremia in older adults. Use with caution in older adults and monitor sodium concentrations closely when initiating therapy or 1 the dose.

Question 8

Nursing considerations

Answer 8

Monitor BP, intake, output, and daily weight and assess feet, legs, and sacral area for edema daily.
• Assess patient, especially if taking digoxin, for anorexia, nausea, vomiting, muscle cramps, paresthesia, and confusion. Notify health care professional if these signs of electrolyte imbalance occur. Patients taking digoxin are at risk of digoxin toxicity because of the potassium-depleting effect of the diuretic.
• If hypokalemia occurs, consideration may be given to potassium supplementation or decreasing dose of diuretic.
• Assess patient for allergy to sulfonamides. Assess patient for skin rash frequently during therapy. Discontinue diuretic at first sign of rash; may be life-threatening. Stevens-Johnson syndrome may develop. Treat symptomatically; may recur once treatment is stopped.
• Hypertension: Monitor BP before and periodically during therapy.
• Monitor frequency of prescription refills to determine compliance.
Lab Test Considerations
• Monitor electrolytes (especially potassium), blood glucose, BUN, serum creatinine, and uric acid levels before and periodically during therapy.
• May cause increased serum and urine glucose in diabetic patients.
• May cause increased serum bilirubin, calcium, creatinine, and uric acid, and decreased serum magnesium, potassium, sodium, and urinary calcium concentrations.
• May cause increased serum cholesterol, low-density lipoprotein, and triglyceride concentrations.

Question 9

What is it used for?

Answer 9

Hypertension.
Edema associated with: HF, Renal impairment, Cirrhosis, Glucocorticoid therapy,
ACTION
Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule. Promotes excretion of chloride, potassium, hydrogen, magnesium, phosphate, calcium and bicarbonate. May produce arteriolar dilation.
Therapeutic Effects: Lowering of BP in hypertensive patients and diuresis with mobilization of edema.