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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 ]
Contraindications [ edit ] Thiazide diuretics increase the excretion of sodium and potassium ions and decrease the excretion of calcium ions and uric acid so they are contraindicated in patients with hyponatraemia , hypokalaemia , hypercalcaemia and hyperuricaemia .
Diuretics act primarily by reducing the reabsorption of sodium at different sites of the renal tubular system and consequently promoting the elimination of sodium and water with increased urine output. [3] Loop diuretics: furosemide, bumetanide, torsemide, ethacrynic acid; Thiazide diuretics: chlorothiazide, hydrochlorothiazide
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]
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.
Diuretics, which lower blood pressure directly by causing the kidney to produce more ... "Thiazide diuretic medications should be taken in the morning hours to prevent frequent urination at ...
All thiazide diuretics including hydrochlorothiazide can inhibit excretion of uric acid by the kidneys, thereby increasing serum concentrations of uric acid. This may increase the incidence of gout in doses of ≥ 25 mg per day and in more susceptible patients such as male gender of <60 years old. [23] [24] [25] Hyperglycemia, high blood sugar
The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect. [ 1 ] [ 2 ] That is, the reduction in blood pressure is not due to decreased blood volume resulting from increased urine production , but occurs through other mechanisms and at lower doses than that required to ...