Chlorothiazide

Chlorothiazide is an antihypertensive agent and belongs to the class thiazide diuretic. The drugs in this class are formally called benzothiadiazide, usually shortened to thiazides. It increases the urination and reduces the amount of water and sodium retained by the body. The nature of the hetrocyclic rings and the substitution on these ring may vary among the congeners but all of them retain a unsubstituted sulfonamide group. Development of thiazides and other modern diuretics began when a perceptive physician noticed that patients receiving sulfanilamide, an early antimicrobial agent, developed metabolic acidosis and a very alkaline urine. Careful study revealed that the drug was causing sodium bicarbonate diuresis. The realization that it could be useful diuretic led first to the development of acetazolamide and then to the thiazides.

Brands
Adult Dose
Dose: 1.786 to 14.286 mg/kg
Single Dose: 8 (8.036)
Frequency: 12 hourly
Route: PO
Instructions: -
Neonatal
Dose: 10 mg/kg
Single Dose: 10 (10)
Frequency: 12 hourly
Route: Intravenous
Instructions:
Paedriatic
Dose: 10 to 20 mg/kg
Single Dose: 15 (15)
Frequency: 12 hourly
Route: Oral
Instructions: (Not exceeding 375 mg/day) in infants up to 2 years or 1000mg/day in children 2 to 12 year.
Characteristics
. It is of Synthetic origin and belongs to Benzothiadiazine. It belongs to NaCl cotransport inhibitor pharmacological group on the basis of mechanism of action and also classified in Diuretic Thiazide pharmacological group.The Molecular Weight of Chlorothiazide is 295.70. Its pKa is 6.7.
Contraindications
'Chlorothiazide is contraindicated in conditions like Hypercalcaemia,Addison''s disease,Renal failure,Anuria,Oliguria,Hepatic failure,Severe sodium and fluid depletion.'
Effects
The severe or irreversible adverse effects of Chlorothiazide, which give rise to further complications include Hyponatremia, Carbohydrate intolerance, Hyponatremia, Carbohydrate intolerance.Chlorothiazide produces potentially life-threatening effects which include Cardiac arrhythmias, Pancreatitis. which are responsible for the discontinuation of Chlorothiazide therapy.The signs and symptoms that are produced after the acute overdosage of Chlorothiazide include Hypotension, Coma, Fall in intravascular volume, Decreased GFR.The symptomatic adverse reactions produced by Chlorothiazide are more or less tolerable and if they become severe, they can be treated symptomatically, these include Weakness, Dizziness, Nausea, Hallucination, Hyperuricemia, Muscle pain, Loss of appetite, Seizures, dizziness.
Indications
Chlorothiazide is primarily indicated in conditions like Congestive heart failure, Edema in cirrhosis with ascites, Hypertension, Nephrotic syndrome, Prevention of renal stone formation, and can also be given in adjunctive therapy as an alternative drug of choice in Hepatic cirrhosis with ascites.
Interactions
Chlorothiazide is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlbuterolhypokalemia may be enhanced by co adminstration of diruretcs such as chlorothiazide wtih salbutamol Should not use concurrently without doctors prescription.AlcoholAllopurinolAmphotericin BAscorbic AcidAstemizoleCarbenoxolone (Na)DiazoxideHalofantrine (HCl)LithiumMetoclopramide (HCl)NateglinideConcurrent use may reduce the hypoglycemic action of Nateglinide.Noradrenaline (Acid Tartrate)PimozidePromethazine (HCl)Propantheline (Br)Sotalol (HCl)TerfenadineTetracycline (HCl)Tubocurarine (Cl) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Test for 17-ketosteroids. Increases serum protein bound iodine levels.
Risks
Drug should not be given to Pregnant Mothers.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab, Susp, Inj Store Below 40°C. Protect from Sunlight and Moisture.
Warnings
Chlorothiazide should be used with caution in patients with gout, diabetes or any allergy especially to sulfa drugs. Thiazide diuretics increase sensitivity to sunlight, avoid prolonged sun exposure, use sunscreen and wear protective clothing. This medication should be used during pregnancy or lactation only if clearly needed. Avoid any drugs that increase heart rate or cause excitation like decongestants (found in cough and cold products) because it may counteract blood pressure medicine.
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