Thiazide Diuretic
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Contents |
More Specific Terms
- bendroflumethiazide (Naturetin)
- benzthiazide (Exna)
- chlorothiazide (Diuril)
- chlorthalidone (Hygroton)
- hydrochlorothiazide (HCTZ, HydroDIURIL, Oretic, Esidrix)
- hydroflumethiazide (Diucardin)
- indapamide (Lozol)
- methyclothiazide (Aquatensin Enduron)
- metolazone (Zaroxolyn, Diulo, Mykrox)
- polythiazide (Renese)
- trichlormethiazide (Metahydrin, Naqua)
Introduction
- Site of action: distal tubule. May be useful in treatment of hypocalcemia.
Pharmacokinetics
- renally cleared
- NOT useful in patients with creatinine clearance < 30 mL/min
Adverse-effects
-
- increased risk of diabetes, relative risk 1.2-1.5 [5]
Drug-interactions
- potentiation of lithium toxicity
- lessening of anticoagulant effect of warfarin
- enhancement of digitalis toxicity
- enhancement of effects of muscle relaxants
- drug interaction(s) of antiarrhythmic agents in combination with diuretics
- drug interaction(s) of beta-2 adrenergic receptor agonists with thiazide diuretics
- drug interaction(s) of lithium carbonate with thiazide diuretics
- drug interaction(s) of diuretics with angiotensin II receptor antagonists
- drug interaction(s) of diuretics with ACE inhibitors
- drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
- drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
Mechanism-of-action
- enhances secretion of Na+, Cl- & H2O by interfering with Na+ & Cl- transport across the renal tubular epithelium mediated by SLC12A3
- site of action: distal tubule.
- thiazides also effect the excretion of other electrolytes including K+ & HCO3-
- inhibits tubular excretion of Ca+2
More General Terms
References
- Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 137
- Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 473
- Taylor EN et al, Antihypertensive medications and the risk of incident type 2 diabetes. Diabetes Care 2006; 29:1065 PMID: [1]
- Prescriber's Letter 14(1): 2007 Thiazides and Diabetes Detail-Document#: [2] (subscription needed) [3]
- Prescriber's Letter 18(3): 2011 Prescriber's Letter 19(2): 2012 COMMENTARY: Thiazides for Hypertension CHART: Comparison of Commonly Used Diuretics Detail-Document#: [4] Detail-Document#: [5] (subscription needed) [6]
