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Thiazide (/ ˈ θ aɪ ə z aɪ d /) refers to both a class of sulfur-containing organic molecules [1] and a class of diuretics based on the chemical structure of benzothiadiazine. [2] The thiazide drug class was discovered and developed at Merck and Co. in the 1950s. [ 3 ]
Hydrochlorothiazide, sold under the brand name Hydrodiuril among others, is a diuretic medication used to treat hypertension and swelling due to fluid build-up. [4] Other uses include treating diabetes insipidus and renal tubular acidosis and to decrease the risk of kidney stones in those with a high calcium level in the urine. [4]
Loop diuretics usually have a ceiling effect whereby doses greater than a certain maximum amount will not increase the clinical effect of the drug. Also, there is a threshold minimum concentration of loop diuretics that needs to be achieved at the thick ascending limb to enable the onset of abrupt diuresis. [10]
Since most of the sodium in the lumen has already been reabsorbed by the time the filtrate reaches the distal convoluted tubule, thiazide diuretics have limited effects on water balance and on electrolyte levels. [4] Nevertheless, they can be associated with low sodium levels, volume depletion, and low blood pressure, among other adverse effects.
Serious side effects may include low blood pressure, kidney problems, allergic reactions, and electrolyte problems. [1] Use in pregnancy and breastfeeding is not recommended. [3] Losartan works by blocking the effects of angiotensin II while hydrochlorothiazide works by decreasing the ability of the kidneys to absorb electrolytes. [1]
The effect is an electrolyte imbalance similar to that seen with thiazide diuretic therapy (which causes pharmacological inhibition of NCC activity). [4] Gitelman syndrome was formerly considered a subset of Bartter syndrome until the distinct genetic and molecular bases of these disorders were identified.
For loop diuretics, thiazide diuretics and thiazide-like diuretics, their common side effects include hypokalemia, hyponatremia, metabolic alkalosis and hyperglycaemia. [4] For potassium-sparing diuretics, its common side effects include hyponatremia, hyperkalemia, metabolic acidosis and sexual dysfunction specifically for spironolactone. [4] [5]
Serious side effects may include kidney problems, allergic reactions, electrolyte problems and low blood pressure. [1] Use in pregnancy is not recommended. [1] Olmesartan works by blocking the effects of angiotensin II while hydrochlorothiazide works by increasing the loss of sodium by the kidneys. [1]