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Published by api-3797941

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Published by: api-3797941 on Oct 17, 2008
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(hye droe klor oht hye' a zide)
Apo-Hydro (CAN), Esidrix, Ezide, HydroDIURIL, Microzide Capsules, Novo-
Hydrazide (CAN), Oretic, Urozide (CAN)
Pregnancy Category B
Drug class
Thiazide diuretic
Therapeutic actions
Inhibits reabsorption of sodium and chloride in distal renal tubule, increasing the
excretion of sodium, chloride, and water by the kidney.
Adjunctive therapy in edema associated with CHF, cirrhosis, corticosteroid, and
estrogen therapy; renal dysfunction
Hypertension as sole therapy or in combination with other antihypertensives

Unlabeled uses: Calcium nephrolithiasis alone or with amiloride or allopurinol to
prevent recurrences in hypercalciuric or normal calciuric patients; diabetes
insipidus, especially nephrogenic diabetes insipidus; osteoporosis

Contraindications and cautions

Contraindicated with allergy to thiazides, sulfonamides; fluid or electrolyte
imbalance; renal disease (can lead to azotemia); liver disease (risk of hepatic
coma); anuria.


Use cautiously with gout (risk of attack); SLE; glucose tolerance abnormalities,
diabetes mellitus; hyperparathyroidism; manic-depressive disorder (aggravated by
hypercalcemia); pregnancy; lactation.

Available forms
Tablets\u201425, 50, 100 mg; solution\u201450 mg/5 mL; capsules\u201412.5 mg
Edema: 25\u2013200 mg daily PO until dry weight is attained. Then, 25\u2013100 mg daily
PO or intermittently, up to 200 mg/day.
Hypertension: Starting dose, 12.5\u201350 mg PO. For maintenance, 25\u2013100 mg daily.
Calcium nephrolithiasis: 50 mg daily or bid PO.

General guidelines: 2.2 mg/kg/day PO in 2 doses.
< 6 mo: Up to 3.3 mg/kg/day in 2 doses.
6 mo\u20132 yr: 12.5\u201337.5 mg/day in 2 doses.
2\u201312 yr: 37.5\u2013100.0 mg/day in 2 doses.

2 hr
4\u20136 hr
6\u201312 hr

Metabolism: Hepatic; T1/2: 5.6\u201314.8 hr
Distribution: Crosses placenta; enters breast milk
Excretion:Urin e

Adverse effects
CNS: Dizziness, vertigo, paresthesias, weakness, headache, drowsiness, fatigue,
leukopenia, thrombocytopenia, agranulocytosis, aplastic anemia, neutropenia
C V:Orthostatic hypotension, venous thrombosis, volume depletion, cardiac
arrhythmias, chest pain
Dermatologic: Photosensitivity, rash, purpura, exfoliative dermatitis, hives,
GI: Nausea, anorexia, vomiting, dry mouth, diarrhea, constipation, jaundice,
hepatitis, pancreatitis
GU: Polyuria, nocturia, impotence, loss of libido
Other: Muscle cramps and muscle spasms, fever, gouty attacks, flushing, weight
loss, rhinorrhea
Altered electrolytes with loop diueretics, amphotericin B, corticosteroids
Increased neuromuscular blocking effects and respiratory depression with
nondepolarizing muscle relaxants
Decreased absorption with cholestyramine, colestipol
Increased risk of cardiac glycoside toxicity if hypokalemia occurs
Increased risk of lithium toxicity
Decreased effectiveness of antidiabetic agents
Drug-lab test
Decreased PBI levels without clinical signs of thyroid disturbance
Nursing considerations
History: Allergy to thiazides, sulfonamides; fluid or electrolyte imbalance; renal
or liver disease; gout; SLE; glucose tolerance abnormalities, diabetes mellitus;
hyperparathyroidism; manic-depressive disorders; lactation, pregnancy
Physical: Skin color, lesions, edema; orientation, reflexes, muscle strength;

pulses, baseline ECG, BP, orthostatic BP, perfusion; R, pattern, adventitious sounds; liver evaluation, bowel sounds, urinary output patterns; CBC, serum electrolytes, blood glucose, liver and renal function tests, serum uric acid, urinalysis

Give with food or milk if GI upset occurs.

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