Chlorothiazide (Diuril)
  • The thiazides act in the distal tubule to decrease sodium reabsorption (inhibits Na/Cl transporter).
    • As a result of decreased sodium and chloride reabsorption, a hyperosmolar diuresis ensues.
  • Delivery of more sodium to the distal tubule results in potassium loss by an exchange mechanism.
  • Thiazides also promote calcium reabsorption, in contrast to loop diuretics.
  •  The initial decrease in blood volume followed by a longer-termed reduction in vascular resistance appears to account for the hypotensive effects of the thiazides.

 

 

 Adverse Effects
  • Potassium depletion is a potentially serious side-effect that may require potassium supplementation and/or concurrent use of potassium-sparing diuretics.
  • Hyperuricemia may occur precipitating gout.
    •  The increase in systemic uric acid is due to a decrease in the effectiveness of the organic acid secretory system.
  •  Diabetic patient may have difficulty in maintaining proper blood sugar levels.