Home Drug Guide Chlorothiazide Sodium

Drug Guide

Generic Name

Chlorothiazide Sodium

Brand Names Diuril

Classification

Therapeutic: Diuretic, antihypertensive

Pharmacological: Thiazide diuretic

FDA Approved Indications

  • Hypertension
  • Edematous states associated with congestive heart failure, cirrhosis of the liver, or renal disease

Mechanism of Action

Chlorothiazide inhibits sodium reabsorption in the distal tubules of the nephron, leading to increased excretion of sodium, chloride, water, and some potassium, thereby reducing blood volume and blood pressure.

Dosage and Administration

Adult: Initial dose typically 250-500 mg once daily or in divided doses. Dose may be adjusted based on response.

Pediatric: Use is based on weight and medical condition; consult specific pediatric dosing guidelines.

Geriatric: Start with lower doses due to increased sensitivity and risk of dehydration or electrolyte imbalance.

Renal Impairment: Use with caution; dose adjustment may be necessary, and benefits should be weighed carefully.

Hepatic Impairment: Use with caution; monitor for alterations in response.

Pharmacokinetics

Absorption: Well absorbed from gastrointestinal tract.

Distribution: Bound to plasma proteins, distributed widely.

Metabolism: Not significantly metabolized.

Excretion: Primarily excreted unchanged in urine.

Half Life: Approx. 6-15 hours, varies with renal function.

Contraindications

  • Hypersensitivity to thiazides or sulfonamide-derived drugs
  • Anuria

Precautions

  • Electrolyte disturbances (hypokalemia, hyponatremia, hypomagnesemia), dehydration, hypersensitivity reactions, gout, diabetes mellitus; use with caution in elderly and patients with renal or hepatic impairment.

Adverse Reactions - Common

  • Electrolyte imbalance (hypokalemia, hyponatremia) (Common)
  • Dizziness, hypotension (Common)
  • Gastrointestinal disturbances (Common)

Adverse Reactions - Serious

  • Jaundice, pancreatitis, blood dyscrasias, hypersensitivity reactions (rare) (Rare)

Drug-Drug Interactions

  • Other antihypertensives, lithium, corticosteroids, NSAIDs

Drug-Food Interactions

  • None significant

Drug-Herb Interactions

  • None well-established

Nursing Implications

Assessment: Monitor blood pressure, electrolyte levels, renal function, hydration status.

Diagnoses:

  • Risk for electrolyte imbalance
  • Risk for hypotension
  • Fluid volume deficit

Implementation: Administer with food to decrease gastrointestinal upset, monitor electrolytes regularly, assess for signs of dehydration.

Evaluation: Assess blood pressure response, electrolyte levels; adjust dose as needed.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report symptoms of electrolyte imbalance (muscle weakness, cramps), dizziness, or unusual bleeding.
  • Maintain adequate hydration; limit alcohol and salt intake as advised.

Special Considerations

Black Box Warnings:

  • None

Genetic Factors: None specific to this drug.

Lab Test Interference: May cause changes in serum electrolyte levels, glucose, and uric acid.

Overdose Management

Signs/Symptoms: Severe electrolyte imbalance, dehydration, hypotension, dizziness.

Treatment: Discontinue drug, provide supportive care, correct electrolyte imbalances, and maintain hydration.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.