Podcast
Questions and Answers
What is the primary reason for adding chlorothiazide (Diuril) in the management of acute decompensated heart failure (ADHF)?
What is the primary reason for adding chlorothiazide (Diuril) in the management of acute decompensated heart failure (ADHF)?
- To promote fluid retention and reduce blood pressure
- To decrease sodium excretion in the proximal tubule
- To overcome diuretic resistance to loop diuretics (correct)
- To increase potassium reabsorption in the kidneys
Which of the following is a potential benefit of sequential nephron blockade using chlorothiazide and furosemide?
Which of the following is a potential benefit of sequential nephron blockade using chlorothiazide and furosemide?
- Enhanced sodium excretion (correct)
- Enhanced potassium reabsorption
- Reduced risk of electrolyte imbalances
- Decreased sodium excretion
In which situation is IV chlorothiazide preferred over oral administration in acute decompensated heart failure (ADHF)?
In which situation is IV chlorothiazide preferred over oral administration in acute decompensated heart failure (ADHF)?
- When the patient has gut edema or poor absorption (correct)
- When a slower onset of action is desired
- When the patient can reliably take oral medications
- When the patient has normal kidney function
What is a typical initial IV dose range for chlorothiazide in treating ADHF?
What is a typical initial IV dose range for chlorothiazide in treating ADHF?
Which electrolyte imbalance is a key concern when administering chlorothiazide?
Which electrolyte imbalance is a key concern when administering chlorothiazide?
Flashcards
Chlorothiazide (Diuril)
Chlorothiazide (Diuril)
A thiazide diuretic used to manage acute heart failure when loop diuretics fail.
Diuretic Resistance
Diuretic Resistance
Condition where high doses of loop diuretics do not effectively promote diuresis.
Sequential Nephron Blockade
Sequential Nephron Blockade
Adding thiazide diuretics like chlorothiazide enhances sodium excretion by targeting different parts of the kidney.
Persistent Volume Overload
Persistent Volume Overload
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IV Administration
IV Administration
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Study Notes
Acute Decompensated Heart Failure (ADHF) and Diuretic Management
- Chlorothiazide (Diuril) is often added to ADHF treatment when loop diuretics (like furosemide) are ineffective.
Indications
- Diuretic Resistance: High doses of loop diuretics fail to produce sufficient urine output.
- Sequential Nephron Blockade: Chlorothiazide, a thiazide-like diuretic, works in the distal tubule, increasing sodium excretion and complementing the loop diuretic's effect.
- Persistent Volume Overload: Patients continue to have excess fluid build-up even with appropriate loop diuretic treatment.
- Metabolic Considerations: When potassium-sparing diuretics (like spironolactone) are not suitable due to high potassium levels (hyperkalemia).
Administration Considerations
- Route: Intravenous (IV) chlorothiazide is preferred for faster action, especially in patients with digestive issues that affect oral medication absorption.
- Dosage: A typical IV dose ranges from 500 to 1000 mg, given once or twice daily.
- Monitoring: Closely watch for potential electrolyte imbalances (hypokalemia, hyponatremia), low blood pressure (hypotension), or worsening kidney function.
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Description
Learn about using chlorothiazide (Diuril) in Acute Decompensated Heart Failure when loop diuretics are not enough. Understand when it's needed for diuretic resistance and volume overload. Explore how it works in sequential nephron blockade.
