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The thiazide diuretics also deplete circulating potassium unless combined with a potassium-sparing diuretic or supplemental potassium. Some authors have challenged thiazides as first line treatment. [55] [56] [57] However, as the Merck Manual of Geriatrics notes, "thiazide-type diuretics are especially safe and effective in the elderly." [58]
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]
The term "thiazide" is also often used for drugs with a similar action that do not have the thiazide chemical structure, such as chlorthalidone, metolazone and indapamide. These agents are more properly termed thiazide-like diuretics. [citation needed] Thiazide diuretics also increase calcium reabsorption at the distal tubule.
A thiazide-like diuretic is a sulfonamide diuretic that has similar physiological properties to a thiazide diuretic, but does not have the chemical properties of a thiazide, lacking the benzothiadiazine molecular structure. Examples include metolazone, chlorthalidone, and indapamide. [1]
Quinethazone (INN, brand name Hydromox) is a thiazide-like diuretic used to treat hypertension. [1] Common side effects include dizziness , dry mouth, nausea , and low potassium levels. References
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 thiazide-like diuretics (indapamide and chlorthalidone) reduce risk of major cardiovascular events and heart failure in hypertensive patients compared with hydrochlorothiazide with a comparable incidence of adverse events. [5] Both thiazide diuretics and thiazide-like diuretics are effective in reducing risk of stroke.
Using a fixed combination of an ACE inhibitor and a chlorosulfamoyl diuretic leads to additive synergy of the antihypertensive effects of the two constituents. Its pharmacological properties are derived from those of each of the components taken separately, in addition to those due to the additive synergistic action of the two constituents, when combined, on vascular endothelium ...