氫氯噻嗪

用途

• 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

給藥方式

可能的副作用

• 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

注意事項與禁忌

• 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.

藥物相互作用

• 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)

常見問題