Thiazide Diuretics

Question 1

Thizide-like Diuretics: Agents

Answer 1

Indapamide (2.5mg every morning)
Bendroflumethiazide
Chlorthalidone (25-50mg every morning)

Question 2

Thizide-like Diuretics: Indications

Answer 2

Hypertension
» where CCB cant be used due to heart/oedema contrainidications
» as a 2nd line medication

Question 3

Thizide-like Diuretics: Mechanism of Action

Answer 3

Thiazides: collective term for thiazide diuretics and thiazide-like diuretics

Thiazides inhibit Na+/Cl- co-transported in distal convoluted tubule of nephron
» prevent reabsorption of Na+
» causes reduced blood volume
» lower BP
SHORT-TERM EFFECT: COUNTERACTED BY RAAS SYSTEM

> > long-term effect is reduced peripheral resistance&raquo_space; vasodilation
mechanism unkown

Question 4

Thizide-like Diuretics: Side Effects

Answer 4

Hyponatraemia&raquo_space; reduced Na+
Hypokalaemia&raquo_space; reduced K+
Polyuria&raquo_space; excessive urine
Hyperglycaemia&raquo_space; increased glucose&raquo_space; reduced K+ causes pancreas to produce less insulin to store glucose
Erectile dysfunction
Postural hypotension

Question 5

Thizide-like Diuretics: Contrainidications

Answer 5

Gout&raquo_space; type of arthritis caused by high levels of uric acid in the blood&raquo_space; thiazide reduces uric acid secretion
Hyponatraemia patients
Hypokalaemia patients

Question 6

Thizide-like Diuretics: Interactions

Answer 6

NSAIDs&raquo_space; may reduce effectiveness of thiazides
Loop diuretics&raquo_space; any medication that reduces serum potassium

Question 7

Thizide-like Diuretics: Monitoring

Answer 7

Urea and electrolytes blood test before and after treatment