And now on to the science and technology news brief hydrochlorothiazide was discovered in 1958 by george – stevens and is one of the most widely used drugs for high blood pressure our medical team is here to report on this drug today now on to you brittany hydrochlorothiazide also known as hc tz is a thiazide diuretic it is a sulfonamide derivative that is used for
Hypertension and edema it is often used as a first-line therapy for hypertension without compelling indications hydrochlorothiazide can be found in combination with numerous blood pressure medications like lisinopril enalapril vanessa pro and low no pain and a brand name products such as been a car is also effective for the treatment of edema and congestive heart
Failure edema associated with corticosteroids and estrogen therapy renown dysfunctions such as nephrotic syndrome ascites associated with cirrhosis and stages one two and three chronic kidney disease hydrochlorothiazide works by inhibiting the sodium and chloride co-transporter on the luminal side of renal tubular epithelium sodium cannot transport across and go
Back into the body so more of it is excreted consequently sodium chloride and water are also excreted from the body this decreases extracellular volume in the body resulting in decreased cardiac output and renal blood flow hydrochlorothiazide acts in the distal convoluted tubules of the nephron here you can see the sodium chloride co-transporter on the luminal
Side in pink and the sodium potassium atpase pump on the interstitial side normally the sodium chloride co-transporter replaces the sodium deficit caused by the sodium potassium atpase pump the chloride is reabsorbed through chloride channels and the potassium goes back into the interstitial through the potassium channels this results in an overall reabsorption of
Sodium and chloride ions thiazide diuretics work by binding to the chloride binding sites blocking the sodium chloride code transporter this blocks sodium and chloride reabsorption resulting in the net excretion of sodium and chloride hydrochlorothiazide is available alone as a tablet or capsule and three-strikes 12.5 25 and 50 milligrams these tablets or capsules
Are taken by mouth and can be crushed and mixed with fluid for patients that have difficulty swallowing metabolism of this medication is not significant it is not a prayer drug and does not require a metabolism to be effective it is excreted primarily unchanged in the urine with 61% or more excreted within the first 24 hours hydrochlorothiazide elimination half-life
Ranges from about five point six to 14 point 8 hours this medication is eliminated renal e and efficacy is diminished invasions with renal insufficiency thiazide diuretics except for mottola zone are considered ineffective in patients with the creatinine clearance less than 30 milliliters per minute hydrochlorothiazide competes with uric acid for elimination and now
Some adverse effects of hydrochlorothiazide patients should be informed of the most common reported adverse effects associated with hctc they can experience both gi and cns effects such as dizzy headache vertigo anorexia abdominal pain diarrhea and constipation this can lead to hypokalemia hyponatremia hypercalcemia hc t z can interact with a drug called digoxin and
If given together close monitoring of the potassium levels is vital this can increase the chance for hypokalemia along with more myocardial localization of the drug digoxin interestingly if taken in combination with an ace inhibitor such as the drug lisinopril there is a decreased likelihood for hypokalemia the addition of the ace inhibitor can possibly increase
The patient’s potassium levels thus equalizing the levels altogether and now for some patient education you will want to remind your patients that hydrochlorothiazide is a diuretic and it will increase urine output they should avoid taking this medication before bedtime this medicine is also a sulfonamide derivative so patients with a confirmed or suspected sulfa
Allergy should use caution when taking hydrochlorothiazide these patients should watch out for skin rashes some of which can be life-threatening such as stevens-johnson syndrome patients should report any rashes to their physician immediately thank you for watching our health news brief and now for your seven-day final exam forecast
Transcribed from video
HCTZ Presentation Med Final By jmskates
