Home Drug Guide Trichlormethiazide

Drug Guide

Generic Name

Trichlormethiazide

Brand Names Naqua, Metahydrin, Trichlorex, Trichlormas

Classification

Therapeutic: antihypertensive, diuretic

Pharmacological: thiazide diuretic

FDA Approved Indications

  • edema associated with congestive heart failure, liver cirrhosis, or renal disease
  • hypertension

Mechanism of Action

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

Dosage and Administration

Adult: Typically 2.5 to 5 mg once daily, titrated based on response.

Pediatric: Use is not well established; consult specific pediatric guidelines.

Geriatric: Start at lower doses due to increased sensitivity and risk of electrolyte disturbances.

Renal Impairment: Adjust dose accordingly; monitor closely.

Hepatic Impairment: Use with caution; no specific dose adjustments established.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, minimal protein binding.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily renal; unchanged drug in urine.

Half Life: Approximately 3-6 hours.

Contraindications

  • Hypersensitivity to sulfonamides or thiazides
  • Anuria

Precautions

  • Electrolyte imbalances (hypokalemia, hyponatremia), gout, diabetic patients, kidney impairment, pregnancy and lactation; monitor blood pressure, electrolytes, renal function regularly.

Adverse Reactions - Common

  • Electrolyte disturbances (hypokalemia, hyponatremia, hypomagnesemia) (Common)
  • Hyperuricemia (Common)
  • Hypersensitivity reactions (Uncommon)

Adverse Reactions - Serious

  • Electrolyte imbalance leading to arrhythmias (Serious, requires monitoring)
  • Pancreatitis (Rare)
  • Blood dyscrasias (agranulocytosis, aplastic anemia) (Rare)

Drug-Drug Interactions

  • Other antihypertensives, corticosteroids, lithium, digitalis

Drug-Food Interactions

  • None significant

Drug-Herb Interactions

  • Potential interactions with diuretic herbs; consult specific herb-drug interaction resources

Nursing Implications

Assessment: Monitor blood pressure, electrolytes (potassium, sodium), renal function.

Diagnoses:

  • Risk for electrolyte imbalance, risk for dehydration, ineffective tissue perfusion.

Implementation: Administer with food to reduce gastrointestinal upset. Monitor intake and output.

Evaluation: Assess blood pressure and electrolytes periodically; ensure therapeutic goals are met.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report signs of electrolyte imbalance (muscle weakness, irregular heartbeat).
  • Maintain adequate hydration.
  • Follow up for blood tests and monitoring.

Special Considerations

Black Box Warnings:

  • Electrolyte and volume depletion; may cause hypotension, dehydration, and electrolyte disturbances.

Genetic Factors: No specific known genetic factors significantly alter response.

Lab Test Interference: May affect serum glucose, electrolytes, uric acid levels.

Overdose Management

Signs/Symptoms: Severe electrolyte depletion, dehydration, hypotension.

Treatment: Administer IV fluids, correct electrolyte imbalances, monitor cardiac status. No specific antidote.

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.