Metolazone Overview and Mechanism of Action

Metolazone Overview

• Trade name: Zaroxolyn, utilized primarily for hypertension and edema management.
• Classified as an antihypertensive and diuretic, specifically a thiazide-like diuretic.

Indications

• Effective for mild to moderate hypertension.
• Addresses edema linked to heart failure (HF) and nephrotic syndrome.

Mechanism of Action

• Reduces blood pressure in hypertensive individuals.
• Promotes diuresis, aiding in the mobilization of edema.
• Efficacy persists even in cases of renal impairment.

Contraindications

• Not suitable for individuals with hypersensitivity or anuria.
• Caution advised for those with a history of sulfonamide allergies.
• Avoid use during lactation.

Cautions

• Use with caution in patients with severe hepatic impairment.
• Not established as safe in patients with significant liver issues.
• Increased sensitivity to drug effects may occur in certain populations.

Adverse Effects

• Common side effects include lethargy, chest pain, hypotension, and palpitations.
• Gastrointestinal disturbances like bloating and cramping may occur.
• Other serious adverse reactions can include drug-induced hepatitis, pancreatitis, and varied electrolyte imbalances (e.g., hyperglycemia, hypokalemia, etc.).

Drug Interactions

• Increased hypotension risk when combined with nitrates or alcohol.
• Risk of hypokalemia heightened with corticosteroids and certain antibiotics.
• Potential for digoxin toxicity enhancement due to potassium depletion.
• Food intake may affect absorption rates of the medication.

Patient Assessment

• Continuous monitoring of blood pressure, daily weight, and fluid intake/output is crucial.
• Assess for edema in extremities, especially in patients on digoxin to prevent toxicity.
• Evaluate for allergy history to sulfonamides and monitor compliance via prescription refills.

Laboratory Test Considerations

• Regular monitoring of electrolytes (especially potassium), blood glucose, and renal function is necessary.
• May affect glucose levels, bilirubin, calcium, and various serum levels noted in laboratory tests.
• Expected lab alterations include an increase in cholesterol and triglycerides.

Patient Education

• Instruct patients to take metolazone consistently at the same time each day, adhering to missed dose guidelines (do not double doses).
• Advise on biweekly weight monitoring and the importance of dietary potassium discussions.
• Emphasize continued medication adherence for chronic hypertension management and instruct on proper blood pressure monitoring techniques.

This quiz covers the essential aspects of Metolazone, including its uses for hypertension and edema, its mechanism of action, and contraindications. Dive into the details surrounding its efficacy and the precautions necessary when prescribing this thiazide-like diuretic.