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NR 565 Cardiac drugs – Download To Score An A+

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Course
NR 565

Institution
Chamberlain College Of Nursing

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Uploaded on September 16, 2024
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NR 565 Cardiac drugs – Download To Score An A+

1. Hydrochlorothiazide

Hydrochlorothiazide (Microzide) is the most widely used thiazide diuretic and will serve as the
prototype for this group. Because of its use in hypertension, hydrochlorothiazide is one of the
most commonly used drugs.

Mechanism of action

Hydrochlorothiazide promotes urine production by blocking the reabsorption of sodium and
chloride in the early segment of the distal convoluted tubule. Retention of sodium and chloride in
the nephron causes water to be retained as well, thereby producing an increased flow of urine.
Because only 10% of filtered sodium and chloride is normally reabsorbed at the site where
thiazides act, the maximal urine flow these drugs can produce is lower than that produced by the
loop diuretics.

• The ability of thiazides to promote diuresis is dependent on adequate kidney function.
These drugs are ineffective when GFR is low (less than 15 to 20 mL/min). Hence, in
contrast to loop diuretics, thiazides cannot be used to promote fluid loss in patients with
severe renal impairment.

Pharmacokinetics and pharmacodynamics

Diuresis begins about 2 hours after oral administration. Effects peak within 4 to 6 hours and may
persist up to 12 hours. Most of the drug is excreted unchanged in the urine.

Common or severe side effects

Hyponatremia, hypochloremia, and dehydration

Hypotension

Hypokalemia

Hyperglycemia

Hyperuricemia

Reduction of HDL cholesterol

Increase in LDL cholesterol and triglycerides

Monitoring needs

Monitor blood pressure and pulse rate; also, patients should weigh themselves daily and evaluate
decreased edema. Have patients monitor for signs or symptoms of hypokalemia.

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