Chlorothiazide [clor oh thye' azide]

  • The thiazides act in the distal tubule to decrease sodium reabsorption (inhibits Na/Cl transporter). As a result of decreased sodium and chloride reabsorption, a hyperosmolar diuresis ensues.

  • Delivery of more sodium to the distal tubule results in potassium loss by an exchange mechanism.

  • Thiazides also promote calcium reabsorption, in contrast to loop diuretics.

  • The initial decrease in blood volume followed by a longer-termed reduction in vascular resistance appears to account for the hypotensive effects of the thiazides.

  • Adverse Effects-

    • Potassium depletion is a potentially serious side-effect that may require potassium supplementation and/or concurrent use of potassium-sparing diuretics.

    • Hyperuricemia may occur precipitating gout. The increase in systemic uric acid is due to a decrease in the effectiveness of the organic acid secretory system

    • Diabetic patient may have difficulty in maintaining proper blood sugar levels.



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