Hypokalemia may cause cardiac arrhythmia and may also sensitize or exaggerate the response of the heart to the toxic effects of digitalis e. Hypokalemia may be avoided or treated by use of potassium sparing diuretics or potassium supplements such as foods with a high potassium content. Although any chloride deficit is generally mild and usually does not require specific treatment except under extraordinary circumstances as in liver disease or renal disease , chloride replacement may be required in the treatment of metabolic alkalosis.
Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction, rather than administration of salt, except in rare instances when the hyponatremia is life threatening. In actual salt depletion, appropriate replacement is the therapy of choice. Hyperuricemia may occur or acute gout may be precipitated in certain patients receiving thiazides.
In diabetic patients dosage adjustments of insulin or oral hypoglycemic agents may be required. Hyperglycemia may occur with thiazide diuretics. Thus latent diabetes mellitus may become manifest during thiazide therapy. If progressive renal impairment becomes evident, consider withholding or discontinuing diuretic therapy. Thiazides have been shown to increase the urinary excretion of magnesium; this may result in hypomagnesemia.
Thiazides may decrease urinary calcium excretion. Thiazides may cause intermittent and slight elevation of serum calcium in the absence of known disorders of calcium metabolism. Marked hypercalcemia may be evidence of hidden hyperparathyroidism. Thiazides should be discontinued before carrying out tests for parathyroid function. Increases in cholesterol and triglyceride levels may be associated with thiazide diuretic therapy.
Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be done at appropriate intervals. Alcohol, barbiturates, or narcotics —potentiation of orthostatic hypotension may occur. Antidiabetic drugs — oral agents and insulin —dosage adjustment of the antidiabetic drug may be required.
Cholestyramine and colestipol resins —Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively.
Corticosteroids, ACTH —intensified electrolyte depletion, particularly hypokalemia. Pressor amines e. Skeletal muscle relaxants, nondepolarizing e. Lithium —generally should not be given with diuretics. Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity. Refer to the package insert for lithium preparations before use of such preparations with Hydrochlorothiazide.
Non-steroidal Anti-inflammatory Drugs —In some patients, the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing and thiazide diuretics.
Therefore, when Hydrochlorothiazide and non-steroidal anti-inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of the diuretic is obtained. The NTP, however, found equivocal evidence for hepatocarcinogenicity in male mice. Hydrochlorothiazide was not genotoxic in vitro in the Ames mutagenicity assay of Salmonella typhimurium strains TA 98, TA, TA , TA , and TA and in the Chinese Hamster Ovary CHO test for chromosomal aberrations, or in vivo in assays using mouse germinal cell chromosomes, Chinese hamster bone marrow chromosomes, and the Drosophila sex-linked recessive lethal trait gene.
There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Thiazides cross the placental barrier and appear in cord blood. There is a risk of fetal or neonatal jaundice, thrombocytopenia, and possibly other adverse reactions that have occurred in adults. Thiazides are excreted in breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue hydrochlorothiazide, taking into account the importance of the drug to the mother.
There are no well-controlled clinical trials in pediatric patients. The following adverse reactions have been reported and, within each category, are listed in order of decreasing severity. Cardiovascular: Hypotension including orthostatic hypotension may be aggravated by alcohol, barbiturates, narcotics or antihypertensive drugs. Digestive: Pancreatitis, jaundice intrahepatic cholestatic jaundice , diarrhea, vomiting, sialadenitis, cramping, constipation, gastric irritation, nausea, anorexia.
Hematologic: Aplastic anemia, agranulocytosis, leukopenia, hemolytic anemia, thrombocytopenia. Hypersensitivity: Anaphylactic reactions, necrotizing angiitis vasculitis and cutaneous vasculitis , respiratory distress including pneumonitis and pulmonary edema, photosensitivity, fever, urticaria, rash, purpura.
Renal: Renal failure, renal dysfunction, interstitial nephritis. Skin: Erythema multiforme including Stevens-Johnson syndrome, exfoliative dermatitis including toxic epidermal necrolysis, alopecia. Whenever adverse reactions are moderate or severe, thiazide dosage should be reduced or therapy withdrawn. The most common signs and symptoms observed are those caused by electrolyte depletion hypokalemia, hypochloremia, hyponatremia and dehydration resulting from excessive diuresis.
This is an opiate used to treat drug addiction and severe, chronic pain. Common side effects may include: nausea, drowsiness, dry mouth and constipation.
Read more here: Is there anything else I can help you with? Common side effects can include: nausea, drowsiness, dizziness and dehydration. Read more here: Do you have any other questions? The pill is oval shaped with R on one side. It is white. V on ba I fuond a small peach colored tablet in my home. This is not one of the prescription drugs that I take.
The imprint is on top half of tablet and a v on bottom half of tablet. The v is kind of strange looking. It is shorter in length on the left hand side and longer on right hand side and there is a small tail at top of each leg on the v. Some of the most common side effects include: nausea, headache, drowsiness and frequent urination. I found unknown pills in my son's room.
One is a small pink pill with and what looks like a V under a line separating the numbers-nothing on other side of pill. The other is yellowish oblong pill with G on one side and MG on other. Does anyone know what these pills are? Orange pill with V on it I have an orange pill with V on one side. Are orange pills with v Diazepam? Found a pill. Need to know what it is It is orange with 6 sides and N8 on the back of it. It is available as a prescription only medicine and is used for diabetes insipidus, edema, high blood pressure, nephrocalcinosis, osteoporosis.
The Mediterranean diet is a healthy way of eating that has been associated with many health benefits. Read on to learn more about the Mediterranean diet.
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