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Thiazide Case Study

Decent Essays
Is there a better medication than a thiazide, and if so what dose should you initiate this medication?
As Eliot’s blood pressure was high, pseudoephedrine was discontinued as well as cimetidine due to the interaction with warfarin. However, Eliot’s blood pressure remaining still high after a month of discontinuing pseudoephedrine. At this point, Eliot need a new prescription to control is hypertension. Therefore, hydrochlorothiazide has started to treat his hypertension.
Thiazide diuretics are recommended as a first line of therapy for hypertensive patients. In 2011, more than 48 million prescriptions were made for hydrochlorothiazide in the United States. Many clinical trials have demonstrated that thiazide diuretics reduce morbidity and
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The efficacy of the treatment can be monitored by observing the blood pressure reading. However, electrolyte disturbance is a common adverse effect of thiazide diuretics as it causes potassium wasting. The frequency of hypokalemia depends on the frequency of administration, dose, diet, and other pharmacologic agents used. During the first two weeks of therapy, electrolytes monitoring is significant. Once a stable state is established, patients are not usually at risk of hypokalemia, unless the dose is increased, extra renal losses of potassium increase, or dietary potassium is reduced. Thiazide diuretics also can cause certain metabolic and endocrine abnormalities such as hypochloremic alkalosis, hypercalcemia and hyponatremia. They can cause photosensitivity and precipitate gout. Hence, it is important to monitor laboratory values periodically in patients on diuretic therapy. The most common drug interactions are pharmacodynamic interactions resulting from potassium depletion caused by the diuretics. Hypokalemia is a risk factor for arrhythmias, and the risk is increased with concomitant therapy with antiarrhythmic agents that prolong the QT interval independently of serum potassium concentration. Therefore, combinations of drugs that can cause hypokalemia such as diuretics, and antiarrhythmic agents require vigilant monitoring of potassium and appropriate replenishment.
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