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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]
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.
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]
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]
Metolazone is a thiazide-like diuretic marketed under the brand names Zytanix, Metoz, Zaroxolyn, and Mykrox. It is primarily used to treat congestive heart failure and high blood pressure . Metolazone indirectly decreases the amount of water reabsorbed into the bloodstream by the kidney , so that blood volume decreases and urine volume increases.
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]
Both thiazide diuretics and thiazide-like diuretics are effective in reducing risk of stroke. [ 5 ] [ 6 ] [ 7 ] Both drug classes appear to have comparable rates of adverse effects as other antihypertensives such as angiotensin II receptor blockers and dihydropyridine calcium channel blockers and lesser prevalence of side-effects when compared ...