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What are thiazide diuretics, and how do they work?
Thiazide diuretics (water pills) are medications that are used to treat high blood pressure (hypertension) and reduce fluid accumulation in the body. They work by reducing the ability of the kidneys to reabsorb salt and water from the urine and into the body thereby increasing the production and output of urine (diuresis).
What are some examples thiazide diuretics?
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For what conditions are thiazide diuretics used?
Thiazide diuretics are used to treat high blood pressure and congestive heart failure as well as the accumulation of fluid and swelling (edema) of the body caused by conditions such as heart failure, cirrhosis, chronic kidney failure, corticosteroid medications, and nephrotic syndrome.
What are the side effects of thiazide diuretics?
Side effects of thiazide diuretics are dose related and include:
- dizziness and lightheadedness,
- blurred vision,
- loss of appetite,
- stomach upset,
- headache, and
Other side effects and adverse reactions are:
- An increased sensitivity to sunlight (prolonged sun exposure should be avoided)
- Owing to their ability to increase the production of urine, these drugs may lower levels in the body of potassium and magnesium which also are present in urine.
- Thiazide diuretics may increase uric acid levels in blood.
- Like other antihypertensive medications, thiazides cause sexual dysfunction.
Are there any differences among the thiazide diuretics?
Thiazide diuretics are similar in effectiveness and usually are not effective in people with severe renal impairment.
With which drugs do thiazide diuretics interact?
Thiazide diuretics can lower potassium and magnesium blood levels since they are both eliminated in urine. Low levels of potassium and magnesium in the blood can result in abnormal heart rhythms, particularly in those who are also taking digoxin (Lanoxin) in addition to a thiazide. Thiazide diuretics can increase the risk of lithium (Eskalith, Lithobid) toxicity by reducing the kidney's ability to eliminate lithium in the urine.
Drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin), naproxen (Naprosyn), and nabumetone (Relafen) can reduce the effectiveness of thiazide diuretics in lowering blood pressure because they may reduce the ability of the kidneys to make urine, particularly in patients who have reduced kidney function.
It is not recommended to use thiazide diuretics with dofetilide (Tikosyn), a drug used for treating abnormal heart rhythms, as this may increase the blood levels of dofetilide (Tikosyn) and cause abnormal heart rhythms. Thiazide diuretics can reduce how the body responds to norepinephrine and render norepinephrine less effective.
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CirrhosisCirrhosis 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 (jaundice), itching, and fatigue.
The prognosis is good for some people with cirrhosis of the liver, and the survival can be up to 12 years; however the life expectancy is about 6 months to 2 years for people with severe cirrhosis with major complications.
Congestive Heart Failure (CHF) OverviewCongestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
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High Blood Pressure Hypertension
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms.
Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure.
The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.
If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
High Blood Pressure Medication
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- Beta blockers
- Calcium channel blockers (CCBs)
- Alpha-beta blockers
Clonidine (Catapres) and minoxidil also are drugs prescribed for the treatment of high blood pressure. Side effects, warnings and precautions, safety information, and pregnancy and breastfeeding safety information should be reviewed prior to taking any medication.
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