Trichlormethiazide

Severe renal impairment; anuria; Addison's disease; hypercalcaemia; porphyria.

Fluid and electrolyte disturbances; hepatic cirrhosis; gout; DM; SLE; severe heart failure; renal impairment. Monitor blood glucose concentrations in patients taking antidiabetics. Elderly.

Electrolyte imbalance (e.g. hypochloraemic alkalosis, hyponatraemia, and hypokalaemia); hyperglycaemia; gout; dry mouth; thirst; weakness; muscle pain and cramp; seizures; GI disturbances; anorexia; sialadenitis; headache; impotence; yellow vision; hypersensitivity reactions; cholestatic jaundice; pancreatitis; blood dyscrasias; glycosuria; dizziness; photosensitivity reactions, postural hypotension, paraesthesia.

Management: Activated charcoal may be used if presented within 1 hr of ingestion. Treatment is symptomatic and aimed at fluid and electrolyte replacement.

Increased neuromuscular blocking action of competitive neuromuscular blockers such as atracurium. Increased risk of hypokalaemia with corticosteroids, corticotropin, β₂agonists e.g. salbutamol, carbenoxolone, amphotericin B or reboxetine. Increased risk of hypotension with other antihypertensives, alcohol, barbiturates or opioids. Reduced antihypertensive effects with corticosteroids, NSAIDs or carbenoxolone. Increased risk of nephrotoxicity with NSAIDs. Increased requirement of hypoglycaemics in diabetic patients.
Potentially Fatal: Increased risk of lithium and digoxin toxicity with concurrent use. Increased risk of arrhythmias with drugs that prolong the QT interval e.g. astemizole, terfenadine, halofantrine, pimozide and sotalol.

Description:
Mechanism of Action: Trichlormethiazide reduces the reabsorption of electrolytes from the renal tubules, hence increasing the excretion of Na and chloride ions and consequently of water. It also reduces the glomerular filtration rate.
Onset: 2 hr.
Duration: 24 hr.

Thuốc lợi tiểu