히드로클로로티아지드

용도

• Treatment of systemic hypertension
• Treatment of systemic hypertension
• Diuretic for heart failure
• Ascites in patients with liver disease
• To reduce calcium oxalate saturation in urine
• Refractory congestive heart failure / Calcium oxalate urolithiasis prevention / Hypertension
• Adjunctive therapy of hyperkalemic periodic paralysis (HyPP)
• Treatment of nephrogenic diabetes insipidus
• Treatment of nephrogenic diabetes insipidus
• Treatment of systemic hypertension
• Prevention of recurrent calcium oxalate uroliths with renal hypercalcuria
• Prevention of recurrent calcium oxalate uroliths with renal hypercalcuria
• Prevention of recurrent calcium oxalate uroliths with renal hypercalcuria
• Diuretic for heart failure (refractory to furosemide alone)
• Adjunctive treatment of heart failure
• Ascites secondary to right-sided heart failure
• Ascites in patients with liver disease
• As a diuretic (general)
• Refractory congestive heart failure / Calcium oxalate urolithiasis prevention / Hypertension

투여 방법

가능한 부작용

• Hypokalemia (most common)
• Hypochloremic alkalosis
• Dilutional hyponatremia
• Hypomagnesemia
• Hypercalcemia (hyperparathyroid-like effects)
• Hypophosphatemia
• Hyperuricemia
• Gastrointestinal reactions (vomiting, diarrhea)
• Polyuria
• Hyperglycemia
• Hyperlipidemias
• Orthostatic hypotension
• Hypersensitivity/dermatologic reactions
• Hypokalaemia
• Hyponatraemia
• Hypochloraemia
• Hyperglycaemia
• Volume contraction (dehydration)
• Activation of the renin-angiotensin-aldosterone system (RAAS)

주의사항 및 금기

• Hypersensitivity to thiazides or sulfonamides
• Anuria
• Pregnancy (relative contraindication in otherwise healthy patients with mild edema)
• Dogs with absorptive (intestinal) hypercalciuria (may result in hypercalcemia)
• Renal impairment (due to reduction in GFR)
• Severe electrolyte imbalances (e.g., severe hypokalaemia or hyponatraemia)
• **Extreme Caution/Avoid**: Severe renal disease, preexisting electrolyte (including hypercalcemia) or water balance abnormalities, impaired hepatic function (may precipitate hepatic coma), hyperuricemia, systemic lupus erythematosus (SLE), or diabetes mellitus. **Monitoring**: Patients with conditions that may lead to electrolyte or water balance abnormalities (e.g., vomiting, diarrhea) should be monitored carefully. Chronic therapy requires monitoring of serum potassium. **Laboratory Test Interferences**: May increase serum amylase, decrease renal excretion of cortisol, falsely decrease total urinary estrogen, cause false-negative histamine tests for pheochromocytoma, elevate serum calcium (discontinue prior to parathyroid testing), compete for PSP secretion, cause false-negative phentolamine tests, decrease protein-bound iodine, slightly reduce T3 resin uptake, and cause false-negative tyramine tests.

약물 상호작용

• Amphotericin B: Increased risk for severe hypokalemia
• Corticosteroids, Corticotropin: Increased risk for severe hypokalemia
• Diazoxide: Increased risk for hyperglycemia, hyperuricemia, and hypotension
• Digoxin: Thiazide-induced hypokalemia, hypomagnesemia, and/or hypercalcemia may increase the likelihood of digitalis toxicity
• Insulin: Thiazides may increase insulin requirements
• Lithium: Thiazides can increase serum lithium concentrations
• Methenamine: Thiazides can alkalinize urine and reduce methenamine effectiveness
• NSAIDs: Thiazides may increase risk for renal toxicity and NSAIDs may reduce diuretic actions of thiazides
• Neuromuscular Blocking Agents: Tubocurarine or other nondepolarizing neuromuscular blocking agents response or duration of effect may be increased
• Probenecid: Blocks thiazide-induced uric acid retention (used to therapeutic advantage)
• Quinidine: Half-life may be prolonged by thiazides (thiazides can alkalinize the urine)
• Vitamin D or Calcium Salts: Hypercalcemia may be exacerbated if thiazides are concurrently administered
• Corticosteroids: Increased risk of developing hypokalaemia.
• Loop diuretics (e.g., furosemide, torasemide): Synergistic diuresis (sequential nephron blockade) but significantly increased risk of hypokalaemia and dehydration.
• Vitamin D: Concurrent administration may exacerbate hypercalcaemia.
• Calcium salts: Concurrent administration may exacerbate hypercalcaemia.

자주 묻는 질문