THIAZIDE LIKE DIURETICS Flashcards
1
Q
MOA
A
inhibiting NA reabsorption at the beginning of the distal convoluted tubule
2
Q
Examples
A
- Bendroflumethiazide
- Chlortalidone
- Indapamide
- Hydrochlorothiazide (in combination products)
3
Q
Duration of action
A
- They act within 1-2 hours of oral administration
- Most have a duration of action of 12-24 hours
4
Q
Administration
A
- Early in the day
- So that diuresis does not interfere with sleep
5
Q
Indication
A
- Oedema (due to CHF)
- Hypertension (given in low doses)
6
Q
Which thiazide and related diuretics are preferred in the management of hypertension?
A
- Chlortalidone
- Indapamide
7
Q
Is Indapamide licensed for heart failure?
A
NO
only HT
8
Q
CI
A
HypoK = risk of cardiac arrythmias
9
Q
Caution
A
- HypoK
- Elderly
10
Q
SE
A
- Gout
- Hyperglycaemia
- Hypokalaemia
- Hyponatraemia
- Hypercalcaemia
- Postural hypotension
11
Q
Which thiazide diuretic has a warning for skin cancer?
A
- Hydrochlorothiaziden (normally used in combination products e.g. Irbesartan and Hydrochlorothiazide)
- Risk of non-melanoma skin cancer
- Associated with long term use
12
Q
Renal impairment
A
- Thiazide and related diuretics are ineffective if eGFR is less than 30 and should be avoided
- Electrolytes should also be monitored for renal impairment
13
Q
Which thiazide-related diuretic is effective in eGFR less than 30?
A
- Metolazone
- but there is a risk of excessive diuresis (USE with caution)
14
Q
Are thiazide-related diuretics contraindicated in diabetes?
A
- Caution
- Hyperglycaemia
15
Q
Monitoring
A
- Electrolytes (e.g. Potassium)
- particularly with high doses and long term use
