Distal diuretics

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Here we mainly include thiazide diuretics (thiazides), for which we distinguish:

  1. 'Renal effect: Thiazides inhibit NaCl reabsorption by distal tubule epithelial cells into blood. At the same time, they increase reabsorption in the distal tubule Ca 2+ ;
  2. extrarenal effect: vasodilation in the postcapillary bed reduces the return of blood to heart and subsequently cardiac output. Vascular resistance decreases after 2-3 weeks.

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The main representatives are:

  • hydrochlorothiazide,
  • chlorthalidone.

Other representatives include: chlorothiazide, trichloromethiazide, bendroflumethiazide, methipamide, indapamide.

Indication[edit | edit source]

Contraindications[edit | edit source]

Side effects and toxicity[edit | edit source]

May manifest hyperglycemia in diabetics and individuals with abnormal results Glucose Test. It is caused by a reduction in the release of insulin from pancreas.
Thiazides lead to an approximately 5-15% increase in cholesterol and lipoproteins (LDL) in the blood. Due to long-term administration, these values ​​may normalize.
This is a serious side effect. It is the result of increased ADH production due to hypovolemia, decreased dilution capacity Kidneys and thirst. It can be prevented by reducing the dose of the diuretic or reducing water intake.

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Source[edit | edit source]

  • lectures by doc. Trejtnar, PharmDr. String