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Thiazide DiureticAka: Hydrochlorothiazide, Chlorthiazide, Chlorthalidone, Indapamide, Metolazone, Zaroxolyn
- Indications
- Hypertension (first-line agent)
- Osteoporosis Prevention (investigational)
- Severe Congestive Heart Failure
- Adjunct to Loop Diuretics
- Meniere's Disease
- Precautions: Renal Insufficiency (GFR <30 ml/min)
- Thiazide Diuretics are minimally effective when GFR falls below 30 ml/min
- Switch to Loop Diuretics at this level of renal insufficiency
- Adverse effects
- Hyperuricemia
- Occurs more often with doses over 25mg
- Less of an issue if avoid Hypokalemia
- Avoid thiazide Diuretics in gout!
- Hyperglycemia
- Hyperlipidemia
- Hypokalemia
- One banana a day is sufficient Potassium Replacement
- Each inch of banana supplies 1 meq of potassium
- Cost benefit is lost when potassium supplement used
- Hyponatremia
- Hypomagnesemia
- Preparations:
- Hydrochlorothiazide (Esidrex, HydroDIURIL)
- Hypertension: 12 to 25 mg orally daily
- Hydrochlorothiazide and Triamterene
- Hctz/Triamterene 25/50 (Dyazide) one daily
- Hctz/Triamterene 50/75 (Maxzide) one daily
- Chlorothiazide (Diuril)
- Hypertension: 125-250 orally daily or divided bid
- Chlorthalidone (Hygroton)
- Hypertension: 12.5 to 25 mg orally daily
- May be preferred over hydrochlorothiazide
- Longer half life than hydrochlorothiazide
- Indapamide (Lozol)
- Hypertension: 1.25 to 5 mg orally daily
- Metolazone (Zaroxolyn)
- Hypertension: 0.5 mg orally daily (max: 1 mg daily)
- CHF with edema: 2.5 mg daily (max: 20 mg/day)
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