Thiazide use in clinical medicine is mainly as either a diuretic or an anti hypertensive.
Thiazide use as diuretics
Thiazides produce effective diuresis in most of the patients with sodium retention and edema. Since there is no special advantage in using any particular preparation, the cheapest of these should be the drug of first choice.
Dosage has to be adjusted in individual cases depending upon the response. Occasionally, patients may develop resistance to these drugs.
In majority of such cases, hypokalemia may be present which needs correction; for this purpose, potassium chloride is commonly used.
Enteric coated thiazide tablets containing potassium chloride should not be used as they can cause intestinal ulcerations. Excessive potassium loss can be prevented by combining thiazide drugs with spironolactone or triameterene.
As the maximum diuretic effect of all thiazides is similar, a patient resistant to the maximum dose of one thiazide is unlikely to respond to another.
Thiazide use as anti hypertensives
In the prevention of recurrent renal calculi: In patients with idiopathic hypercalciuria, hydrochlorthiazide (50 mg. twice a day) reduces the frequency of stone formation.
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