Hypothiazide

Hypothiazide, also known chemically as hydrochlorothiazide, is a diuretic drug that belongs to the class of thiazide diuretics. This drug is widely used to treat high blood pressure (hypertension) and edema associated with heart failure, cirrhosis of the liver, or kidney disease.

Hydrochlorothiazide works by increasing urine output, which helps the body get rid of excess salt and water. It does this by blocking the reabsorption of sodium and chloride in the distal tubules of the kidneys, which leads to an increase in urine volume and, accordingly, a decrease in the volume of fluid in the vessels.

Indications Hypothiazide

1. Hypertension (high blood pressure): Hydrochlorothiazide is often prescribed alone or in combination with other antihypertensive medications to lower blood pressure.
2. Edema associated with heart failure: The drug helps reduce fluid buildup in the body by increasing the excretion of sodium and water through the kidneys, which can relieve swelling associated with heart failure.
3. Edema caused by liver disease or kidney failure: Hydrochlorothiazide may be prescribed to reduce swelling that occurs when the liver or kidneys are not functioning properly.
4. Nephrogenic diabetic nephropathy: In some cases, hydrochlorothiazide may be used to manage diabetic nephropathy (kidney damage caused by diabetes diabetes).

Release form

Hypothiazide (hydrochlorothiazide) is usually available in tablet form to be taken orally.

Pharmacodynamics

The mechanism of action of hydrochlorothiazide is its ability to increase the excretion of sodium and chlorine from the body by inhibiting the reabsorption of these ions in the kidneys. This leads to a decrease in the volume of circulating blood and a decrease in the volume of fluid in the vascular bed. A decrease in circulating blood volume leads to a decrease in blood volume, which in turn reduces blood pressure.

In addition, hydrochlorothiazide may also increase the sensitivity of blood vessels to vasoconstrictor substances such as adrenaline, which also helps lower blood pressure.

Pharmacokinetics

1. Absorption: Hydrochlorothiazide is usually rapidly and completely absorbed from the gastrointestinal tract after oral administration.
2. Metabolism: Hydrochlorothiazide is metabolized in the liver, mainly through conjugation with glucuronic acid.
3. Elimination: Hydrochlorothiazide and its metabolites are excreted primarily by the kidneys. Most of the dose is excreted unchanged during the first 24 hours after administration.
4. Half-life: The half-life of hydrochlorothiazide is approximately 5-15 hours. This means that during approximately this time the level of the drug in the body is reduced by half.
5. Continuous exposure: When hydrochlorothiazide is taken regularly, its diuretic effect may persist for a long time even after a single dose due to accumulation in tissues.
6. Side Effects: As with any medicine, hydrochlorothiazide has side effects, including electrolyte disturbances (such as hypokalemia), hyperuricemia, hyperglycemia, hyponatremia, and fluid imbalance.
7. Individual variability: Pharmacokinetics may be altered in patients with renal or hepatic impairment.

Dosing and administration

1. Dosage:

   • The usual starting dosage for adults is usually 12.5 mg per day.
   • The dosage can be increased to 25-50 mg per day if necessary.
   • For children, the dosage is determined depending on weight and is usually 0.5-2 mg per kilogram of body weight per day, divided into several doses.

2. Method of application:

   • Hydrochlorothiazide is usually taken orally, swallowing the tablet whole with water.
   • It can be taken with meals or on an empty stomach.
   • Take at the same time every day to maintain a stable level of the drug in the body.

3. Notes:

   • It is important to follow the recommended dosage and instructions for the drug.
   • Before changing the dosage or regimen of hydrochlorothiazide, you should consult your doctor.
   • Do not exceed the recommended dosage without consulting your doctor.

Use Hypothiazide during pregnancy

1. Effect on the fetus:

   • Hydrochlorothiazide is an FDA category B drug for safety during pregnancy. This means that animal studies have shown no risk to the fetus, but no controlled studies have been conducted in pregnant women.
   • There is a theoretical risk that thiazides, including hydrochlorothiazide, may affect fluid and electrolyte balance, which could affect the fetus.

2. Effects on pregnancy:

   • Thiazides may reduce plasma volume, potentially leading to decreased placental perfusion and subsequent fetal growth restriction and other complications.

3. Recommendations:

   • It is generally recommended to avoid the use of hydrochlorothiazide during pregnancy, especially in the second and third trimesters, due to possible risks and limited safety information.
   • If treatment for high blood pressure during pregnancy is necessary, it is better to use alternative medications known to be safe for pregnant women, such as methyldopa or nifedipine.

Contraindications

1. Known allergy or intolerance: People with a known allergy to hydrochlorothiazide or other thiazide diuretics should avoid its use.
2. Hyperkalemia: Hydrochlorothiazide may cause an increase in blood potassium levels, so its use may be contraindicated in patients with hyperkalemia.
3. Hyponatremia: Treatment with hydrochlorothiazide may result in decreased blood sodium levels, so it should be used with caution in patients with hyponatremia.
4. Renal failure: In patients with renal failure, especially severe renal failure, hydrochlorothiazide may impair renal function and is contraindicated.
5. Hypercalcemia: Hydrochlorothiazide may be contraindicated in the presence of hypercalcemia (increased blood calcium levels).
6. Decompensated heart failure: Hydrochlorothiazide may worsen heart failure if it decompensates.
7. Pregnancy and breastfeeding: The use of hydrochlorothiazide during pregnancy and breastfeeding may be contraindicated. Use should only be carried out for strict medical reasons and under the supervision of a physician.

Side effects Hypothiazide

1. Dehydration: Hydrochlorothiazide may cause significant loss of fluid and electrolytes through the kidneys, which may cause dehydration.
2. Hypokalemia: This drug may reduce potassium levels in the blood, which may cause muscle weakness, fatigue, irregular heart rhythm, and other symptoms.
3. Hyponatremia: Hydrochlorothiazide can cause low sodium levels in the blood, which can lead to headaches, drowsiness, muscle cramps, and other symptoms.
4. Hyperuricemia: Increased levels of uric acid in the blood, which can worsen gout or lead to the formation of urinary stones.
5. Hyperglycemia: Hydrochlorothiazide may increase blood glucose levels, which may be problematic for people with diabetes.
6. Hypercalcemia: Increased levels of calcium in the blood, which can lead to fatigue, nausea, vomiting, constipation and other symptoms.
7. Hyperlipidemia: Increased levels of blood lipids, including cholesterol and triglycerides.
8. Hyperurinemia: Increased levels of urea in the blood, which may be an indicator of impaired renal function.

Overdose

1. Severe dehydration: Since hydrochlorothiazide increases the removal of fluid from the body, an excess of the drug can lead to significant fluid loss and dehydration. This can manifest itself as dry skin and mucous membranes, low urine levels, weakness, seizures and even low blood pressure.
2. Electrolyte disturbances: Overdose can cause a decrease in blood levels of potassium (hypokalemia), sodium (hyponatremia), magnesium (hypomagnesemia) and other electrolytes, which can lead to heart rhythm disturbances, muscle cramps, fatigue and even internal organs. li>
3. High blood pressure: The intense diuretic effect of hydrochlorothiazide can cause a sharp decrease in blood pressure (hypotension), which in turn can lead to dizziness, orthostatic reactions and, in rare cases, fainting.
4. Renal failure: Overdose of hydrochlorothiazide may lead to acute renal failure due to its diuretic effect, which may require urgent medical attention.

Interactions with other drugs

1. Medicines that increase potassium levels: Hydrochlorothiazide may increase potassium loss, so concomitant use with other drugs that may also decrease blood potassium levels (eg, digoxin, lithium, some diuretics, amphotericin B) may result in hypokalemia.
2. Antihypertensive drugs: Combining hydrochlorothiazide with other antihypertensive drugs, such as calcium channel blockers, angiotensin-converting enzyme inhibitors (ACEIs), or aldosterone antagonists, may result in an additional reduction in blood pressure.
3. Heart failure medications: Taking hydrochlorothiazide with medications used to treat heart failure, such as digoxin or angiotensin-converting enzyme inhibitors (ACE inhibitors), may increase their effect.
4. Nephrotoxic drugs: Hydrochlorothiazide may increase the nephrotoxicity of drugs, such as some nonsteroidal anti-inflammatory drugs (NSAIDs) or aminoglycoside antibiotics.
5. Medicines that increase blood urea levels: Hydrochlorothiazide may increase blood urea levels when combined with drugs that can also increase blood urea levels, such as some nonsteroidal anti-inflammatory drugs (NSAIDs).