Hydrochlorothiazide Overview and Usage

Study Notes

Hydrochlorothiazide Overview

Trade names include Esidrix, Hydro-chlor, Microzide, and Oretic, with variants available in Canada.
Classified as an antihypertensive and diuretic, primarily used to manage high blood pressure.

Pregnancy and Dosage Information

Assigned pregnancy category B, indicating no proven risk in human studies.
Typical adult dosage is 12.5 mg daily for hypertension management.
Oral solution dosage ranges from 25 to 100 mg daily, either as a single dose or divided into two doses.
For children over 6 months: 1 to 2 mg/kg daily, while for those under 6 months, up to 3 mg/kg daily.

Mechanism of Action

Functions as a thiazide diuretic, facilitating sodium, chloride, and water movement into the nephron's distal convoluted tubule.
Results in decreased extracellular fluid volume and blood pressure; peripheral vascular resistance remains lower after initial diuretic effects plateau.

Contraindications and Adverse Reactions

Contraindicated in patients with anuria, hypersensitivity to hydrochlorothiazide or similar compounds, and renal failure.
Potential adverse reactions span various systems including:
- CNS: dizziness, headaches, and insomnia.
- CV: hypotension and orthostatic hypotension.
- GI: nausea, vomiting, and abdominal cramps.
- Skin: rashes, exfoliative dermatitis, and Stevens-Johnson syndrome.
- HEME: blood disorders such as agranulocytosis and thrombocytopenia.

Nursing Considerations

Administer in the morning and early evening to mitigate nocturia.
Closely monitor fluid intake/output, daily weight, blood pressure, and serum electrolytes, particularly potassium.
Assess for signs of hypokalemia (muscle weakness, cramps) and monitor renal function via BUN and creatinine levels.
Be wary of increased gout attacks in patients with pre-existing gouty arthritis.

Patient Education

Advise taking the medication during the day to reduce nighttime disturbances for urination.
Recommend consumption with food or milk to alleviate GI side effects.
Instruct weight monitoring at consistent times and report weight gains exceeding specified thresholds.
Encourage high-potassium dietary choices, such as bananas and citrus fruits.
Advise careful positional changes to reduce risks associated with orthostatic hypotension.
Urge reporting of decreased urination, muscle cramps, or unusual bleeding.

Description

This quiz covers the essential aspects of Hydrochlorothiazide, including its classification as an antihypertensive and diuretic, its dosage guidelines, and mechanisms of action. Additionally, it addresses contraindications and potential adverse reactions, providing a comprehensive overview for learners.