Home Drug Guide Hydrochlorothiazide

Drug Guide

Generic Name

Hydrochlorothiazide

Brand Names Esidrix, Hydrodiuril, Oretic, Microzide, Hydro-d, Zide, Hydrochlorothiazide Intensol, Inzirqo

Classification

Therapeutic: Diuretic, Antihypertensive

Pharmacological: Thiazide diuretic

FDA Approved Indications

  • Edema associated with congestive heart failure, liver cirrhosis, corticosteroid or estrogen therapy
  • Hypertension

Mechanism of Action

Inhibits sodium reabsorption in the distal tubules of the kidney, leading to increased excretion of sodium, chloride, and water, which helps reduce blood volume and blood pressure.

Dosage and Administration

Adult: Typically 25-100 mg daily in one or two divided doses, adjusted based on response.

Pediatric: Dosing varies; generally, 1-2 mg/kg/day divided into one or two doses, up to a maximum of 3 mg/kg/day.

Geriatric: Start at lower doses due to increased sensitivity; monitor renal function and electrolytes closely.

Renal Impairment: Dose adjustment may be necessary; monitor renal function regularly.

Hepatic Impairment: Use with caution; no specific dosage adjustment established.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed; crosses the placenta; minimal in breast milk.

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged.

Excretion: Excreted mainly unchanged in the urine.

Half Life: about 6-15 hours.

Contraindications

  • Anuria
  • Hypersensitivity to hydrochlorothiazide or sulfonamides

Precautions

  • Electrolyte imbalances (hypokalemia, hyponatremia), gout, diabetes mellitus, renal impairment, sulfa allergy.

Adverse Reactions - Common

  • Electrolyte disturbances (hypokalemia, hyponatremia) (Common)
  • Hypotension (Common)
  • Dizziness or lightheadedness (Common)

Adverse Reactions - Serious

  • Electrolyte imbalance leading to arrhythmias (Uncommon)
  • Jaundice or hepatotoxicity (Rare)
  • Allergic reactions, including rash or Stevens-Johnson syndrome (Rare)

Drug-Drug Interactions

  • Other antihypertensives, Lithium, corticosteroids, digitalis

Drug-Food Interactions

  • Limit alcohol intake as it may enhance hypotensive effects.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, electrolytes, renal function, and hydration status.

Diagnoses:

  • Risk for electrolyte imbalance
  • Risk for hypotension

Implementation: Administer with food or milk to reduce gastrointestinal irritation; monitor vital signs and labs as ordered.

Evaluation: Assess blood pressure, electrolyte levels, and signs of adverse reactions regularly.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Eat potassium-rich foods if advised by healthcare provider.
  • Report any dizziness, weakness, or irregular heartbeat.
  • Avoid alcohol and excessive sunlight exposure.

Special Considerations

Black Box Warnings:

  • Sulfonamide hypersensitivity reactions.

Genetic Factors: None specific.

Lab Test Interference: May cause falsely elevated blood glucose and uric acid levels.

Overdose Management

Signs/Symptoms: Electrolyte disturbances, dehydration, hypotension, dizziness.

Treatment: Replace fluids and electrolytes as needed, monitor vital signs, and provide supportive care.

Storage and Handling

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

Stability: Stable under recommended 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.