Hypertension - Diuretics - Thiazide

Question 1

What are the 5 major classes of diuretics?

Answer 1

(1) Thiazides
(2) Loop
(3) Potassium Sparing
(4) Osmotic
(5) Carbonic Anhydrase Inhibitors

Question 2

Which class of diuretics are the first line treatment for uncomplicated HTN?

Answer 2

Thiazides

Question 3

Which class of diuretics are the first line treatment for edematous disorders?

Answer 3

Loop diuretics

Question 4

Which class of diuretics are the first line treatment to correct a K imbalance OR to correct excess aldosterone?

Answer 4

Potassium sparing diuretics

Question 5

Which class of diuretics are the first line treatment for glaucoma?

Answer 5

Carbonic Anhydrase Inhibitors

Question 6

Which class of diuretics are the first line treatment for cerebral edema?

Answer 6

Osmotic diuretics

Question 7

Which class of diuretics can decrease the risk of stroke in patient’s with mild heart failure?

Answer 7

Diuretics

Question 8

Besides being the initial monotherapy for uncomplicated hypertension, what are 2 other benefits of thiazide diuretics?

Answer 8

(1) Prevent CHF

(2) Lower urine calcium

Question 9

What is the difference between thiazides and thiazide like diuretics?

Answer 9

Thiazide like diuretics lack benzothiadazine structurefound on thiazide diuretics

Question 10

Name 2 common thiazide diuretics

Answer 10

1. Chlorothiazide (Diurel)

2. Hydrochlorothiazide (Microzide)

Question 11

In patients who were not initially treated with a thiazide diuretics, start with

Answer 11

Thiazide like diuretic (Indapamide, metolazone, chlothalidone)

Question 12

Mechanism of action for Thiazide diuretics

Answer 12

Block the NaCl co transporter at the distal convoluted tubule (DCT)
NaCl reabsorption is inhibited
Na, Cl and H20 is excreted

Question 13

Adverse effects of thiazides
(1) Related to blood sugar
(2, 3) Related to electrolytes 
(4) Lipid disorder
(5) Joints
(6) Sunlight
(7) Sexual health

Answer 13

(1) Glucose intolerance is impaired which can cause hyperglycemia in type 2 diabetics
(2) Hypokalemia
(3) Hyponatremia
(4) Hyperlipidemia (with high doses)
(5) Hyperuricemia (gout)
(6) Photosensitivity
(7) Sexual dysfunction

Question 14

Contraindication to using thiazides

Answer 14

Pt.’s with an underlying renal disease
GFR <30-40
*Sulfa may be okk

Question 15

Drug interactions for thiazides

(1) Tx medictaion for gout
(2) Loop + Thiazide
(3) Anti-diabetic medications
(4) Mental health
(5) Digoxin

Answer 15

(1) Probenecid
(2) Monitor for hypokalemia
(3) Adjust
(4) Lithium levels
(5) Monitor for weakness, cramps, and heart rate

Question 16

SE of Thiazides

Answer 16

Decrease K

Decrease Urinary Calcium to treat kidney stones