Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAMES: Hydrodiuril, Ezide, Hydro-Par, Microzide, and many combinations
with other drugs
DRUG CLASS AND MECHANISM: Hydrochlorothiazide is a diuretic (water
pill) used for treating high blood pressure (hypertension) and accumulation of
fluid. It works by blocking salt and fluid reabsorption in the kidneys, causing
increased urine output (diuresis). The mechanism of its action in lowering high
blood pressure is not well understood.
STORAGE: Hydrochlorothiazide should be stored at room temperature, 15
to 30 C (59 to 86 F), in a tight, light-resistant container.
PRESCRIBED FOR: Hydrochlorothiazide is used to treat excessive fluid
accumulation and swelling (edema) of the body caused by heart failure,
cirrhosis, chronic kidney failure, corticosteroid medications, and nephrotic
syndrome. It also is used alone or in conjunction with other blood pressure
lowering medications to treat high blood pressure. Although hydrochlorothiazide
is approved for treating edema in cirrhosis of the liver, it is rarely used
because of the availability of more potent diuretics that are more effective.
Hydrochlorothiazide can be used to treat calcium-containing kidney stones
because it decreases the amount of calcium excreted by the kidneys in the urine
and thus decreases the amount of calcium in urine to form stones.
DOSING: Hydrochlorothiazide may be taken with or without food. The
usual adult dose for hypertension is 12.5 to 50 mg once daily. The usual adult
dose for treating edema is 25-100 mg once daily or in divided doses.
DRUG INTERACTIONS: Hydrochlorothiazide reduces the elimination of
lithium (Lithobid) by the kidneys and can lead to lithium toxicity.
Nonsteroidal antiinflammatory
drugs, for example, ibuprofen, may reduce the blood pressure effects
of hydrochlorothiazide.
Blood sugar levels can be elevated by hydrochlorothiazide, necessitating
adjustment in the doses of medications that are used for treating diabetes.
Combining hydrochlorothiazide with corticosteroids may increase the risk for
low levels of blood potassium and other electrolytes. Low blood potassium can
increase the toxicity of digoxin
(Lanoxin). Cholestyramine
(Questran, Questran Light) and colestipol
(Colestid) bind to
hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by
43%-85%.
PREGNANCY: There are no adequate studies of hydrochlorothiazide in
pregnant women.
NURSING MOTHERS: Hydrochlorothiazide is excreted in breast milk. There
is some evidence that it may reduce production of
breast milk.
Hydrochlorothiazide can aggravate kidney
dysfunction and is used with caution in patients with kidney disease.
Hydrochlorothiazide can lower blood potassium, sodium, and magnesium levels. Low
potassium and magnesium levels can lead to
abnormalities in heart rhythm,
especially in patients already taking digoxin (Lanoxin). During hydrochlorothiazide
treatment, supplementation with potassium is common to prevent low potassium
levels.
Blood uric acid levels can increase during hydrochlorothiazide
treatment, and this elevation may cause an episode of acute gout in some
individuals.
Thiazide diuretics may increase blood sugar (glucose) levels and
precipitate latent diabetes.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones symptoms and signs are, blood in the urine and pain in the abdomen, flank (lower back), or groin. A number of different conditions can lead to kidney stones including: gout, hypercalciuria, people with inflammatory bowel disease, kidney disease, and hypoparathyroidism. Some medications also increase the risk of kidney stones.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Edema is the swelling of tissues as a result of excess water accumulations. Peripheral edema occurs in the feet and legs. There are two types of edema, non-pitting edema and pitting edema. Causes of pitting edema is caused by systemic diseases, most commonly involving the heart, liver, and kidneys. Local conditions that cause edema are thrombophlebitis and varicose veins. Edema is generally treated with medication.
Potassium is an essential electrolyte necessary for cell function. Low potassium (hypokalemia) may be caused by diarrhea, vomiting, ileostomy, colon polyps, laxative use, diuretics, elevated corticosteroid levels, renal artery stenosis, and renal tubular acidosis, or other medications. Symptoms of low potassium include weakness, aches, and cramps of the muscles. Treatment is dependant upon the cause of the low potassium (hypokalemia).
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Heart failure is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats.
Cirrhosis is a complication of many liver diseases that
is characterized by abnormal structure and function of the liver. The diseases
that lead to cirrhosis do so because they injure and kill liver cells, and the
inflammation and repair that is associated with the dying liver cells causes
scar tissue to form. The liver cells that do not die multiply in an attempt to
replace the cells that have died. This results in clusters of newly-formed liver
cells (regenerative nodules) within the scar tissue. There are many causes of
cirrhosis; they include chemicals (such as alcohol, fat, and certain
medications), viruses, toxic metals
(such as iron and copper that accumulate in
the liver as a result of genetic diseases), and autoimmune liver disease in
which the body's immune system attacks the liver.
Why does cirrhosis cause problems?
The liver is an important organ in the body. It performs
many...
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