Hydrochlorothiazide


Hydrochlorothiazide/ Diathiazide                  Preg Risk C

Classifications: A thiazide diuretic that increased sodium and water excretion by inhibiting sodium and chloride reabsorption in the nephrons distal segment.

Adverse reactions:

  CNS: dizziness, vertigo, headache, parasthesia, weakness, restlessness

    CV: volume depletion and dehydration, orthostatic hypotesnion(agravated by alcohol, barbiturates, or antihypertensive drugs), vasculiltis

     Eye: transient blurred vision

     GI: anorexia, nuasea, pancreatitis, epigastric distress, vomiting, abdo pain, diarrhoea, constipation

     GU: polyuria, frequent urinations, renal failure, interstitial nephritis.

    Hepatic: jaundice

       Muculoskeletal: muscle cramps, spasm or weakness    

      Metabolic: hypokalaemia, asymptomatic hyperurincaemia, hyperglycaemia, impaired glucose tolerance, fluid and electrolyte imbalances, including dilutional hyonatraemia, and hypochloraemia, metabolic alkylosis, hypercalcaemia; gout.

     Respiratory: respiratory distress

     Skin: dermatitis, photosensitivity rash, purpura, alopecia, exacerbation of systemic lupus

Contraindications:hypersensitivity

Care considerations:

Cautiously in children, to prevent nocturia, give in the mornings; encourage lifesyle changes (weight loss, smoking alcohol, diet, exercise);monitor bp for drug effectiveness, monitor if person looses fluids(sweating, diarrhoea, vomiting); provide comfort to tolerate drug effects, small frequent meals, access to bathroom, safety if CNS EFFECTS occur; appropriate skin care, environmental control, administer analgesics as needed.Teach about drug.; watch for signs of hypokalaemia( muscle weakness and cramps), advise high potassium diet:citrus, tomatoes, bananas and dates. Not for lactating mothers.

Dose: 25-100 mg PO daily or PO.

Drug-drug: Ace inhibitors, antidiabetics, insulin, antihypertensives, barbiturares, opiates; cardiac glycosides; cholestyramine; corticosterioids, ACTH; Diazoxide; Lithium; NSAIDs, licorice, alcohol.

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