What Is Chlorthalidone?

A thiazide-like diuretic. The molecular formula is C14H11CLN2O4S and the molecular weight is 338.76. Indications Cardiogenic edema, hepatogenic edema and renal edema (such as nephrotic syndrome, acute glomerulonephritis, etc.), edema caused by adrenal cortex hormones or estrogen, hypertension, etc. By inhibiting the reabsorption of sodium chloride in the anterior segment of the distal tubule and the proximal tubule, the Na + -K + exchange between the distal tubule and the collecting duct is increased to achieve a therapeutic effect.

Chlorophthalone

CHLORTRALIDONE TABLETS is a white tablet. Oral absorption is incomplete, mainly binding to intracellular carbonic anhydrase, and little binding to plasma proteins, and increased binding to plasma proteins (mainly albumin) in severe anemia. It works for 2 hours orally, the peak time is 2 hours, and the duration is 24 to 72 hours. T1 / 2 is 35 ~ 50 hours. The reason why the drug has a significantly longer half-life and duration of action than other thiazine drugs is that the drug is mainly excreted and metabolized slowly because it mainly binds to red blood cell carbonic anhydrase. It is mainly excreted from the urine in the original form, partly metabolized in the body, excreted by the extrarenal route, and the biliary tract is not the main excretion route.

Chlorophthalone indications

1. Edema disease, excrete excessive sodium and water in the body, reduce extracellular fluid volume, and eliminate edema. Common ones include congestive heart failure, cirrhotic ascites, nephrotic syndrome, acute and chronic nephritis edema, early chronic renal failure, sodium and water retention caused by adrenal corticosteroids and estrogen treatment.

2. Hypertension can be used alone or in combination with other antihypertensive drugs, mainly for the treatment of essential hypertension.

3. Central or renal diabetes insipidus.

4. Nephrolithiasis is mainly used to prevent the formation of stones containing calcium salts.

Chlorophthalone dosage

1. Commonly used amount for adults: oral, for the treatment of edema disease, 25 ~ 100mg daily, or 100 ~ 200mg every other day; or 100 ~ 200mg daily, for 3 days a week. There are also daily doses up to 400mg. When the glomerular filtration rate of kidney disease is less than 10 ml per minute, the interval between medications should be more than 24 to 48 hours. For the treatment of hypertension, take 25 to 100 mg daily, once a day or once every other day, and adjust the dose according to the antihypertensive effect. The combined application with topical Chinese medicine patches such as topical Li's medicine patches, antihypertensive application patches, and suspension pressure patches can be used in smaller doses, 12.5mg ~ 25mg daily.

2, commonly used in children: oral, according to body weight 2mg / kg, once a day, even 3 days a week, and adjust the dose according to efficacy.

3, drug overdose: gastric overdose should be administered as soon as possible, support, symptomatic treatment, and close follow-up of blood pressure, electrolytes and renal function.

Chlorophthalone adverse reactions

Most adverse reactions are related to dose and duration of treatment. (1) Side effects caused by water and electrolyte disorders are more common. Hypokalemia is more likely to be related to the potassium excretion of thiazide diuretics. Long-term potassium deficiency can damage the renal tubules, severe potassium loss can cause vacuolar changes in the renal tubular epithelium, and cause ectopic heart rate such as severe tachycardia . Low-chlorine alkalosis or low-chlorine, low-potassium alkalosis, thiazines, especially hydrothiazine, often significantly increase chloride excretion. In addition, hyponatremia is not uncommon, causing central nervous system symptoms and aggravating renal damage. Decreased blood volume and renal blood flow caused by dehydration can also reduce glomerular anxiety. The common clinical reactions of the above water and dielectric disorders include dry mouth, thirst, muscle cramps, nausea, vomiting, and extreme fatigue. (2) Hyperglycemia. It can reduce glucose tolerance and increase blood sugar, which may be related to inhibiting insulin release. (3) Hyperuricemia. Interfering with renal tubule excretion of uric acid, a few can induce gout attacks. Because there is usually no joint pain, hyperuricemia is easily overlooked. (4) Allergic reactions, such as rash, urticaria, etc., but are relatively rare. (5) Leukopenia or deficiency, thrombocytopenic purpura, etc. are also rare. (6) Others, such as cholecystitis, pancreatitis, hyposexuality, light sensitivity, color vision disorders, etc., but are rare.

Contraindications to chlorophthalone

No

Precautions for chlorophthalone

(1) Cross-allergy: Cross-allergy with sulfa drugs, furosemide, bumetanib, and carbonic anhydrase inhibitors.

(2) Interference to diagnosis: can cause impaired glucose tolerance, blood sugar, urine glucose, blood bilirubin, blood calcium, blood uric acid, blood cholesterol, triglycerides and low density lipoprotein concentrations, blood magnesium, potassium, Decreased sodium and urine calcium.

(3) The following conditions should be used with caution: People who have no urine or severe renal dysfunction (GRF <20ml / min), due to the poor effect of this class of drugs, can cause drug accumulation and increased toxicity when used in large doses; diabetes; high uric acid Patients with a history of gout or history of gout; severe liver damage, water and electrolyte disorders can induce liver coma; hypercalcemia; hyponatremia; lupus erythematosus, which can aggravate the condition or induce activity; ; sympathectomy (hypertensive effect); infants with jaundice.

(4) Follow-up inspection: blood electrolyte; blood sugar; blood uric acid; blood creatinine, urea nitrogen; blood pressure

(5) The drug should be started from the minimum effective dose to reduce the occurrence of side effects and reduce the secretion of reflex renin and aldosterone.

(6) In patients with a tendency to hypokalemia, potassium supplementation or potassium diuretics should be used as appropriate. When taking the medicine once a day, it should be taken in the morning to avoid an increase in the number of micturitions at night. Intermittent medication (not tomorrow's medication) can reduce the chance of dielectric disorder.

(7) Pregnant women and lactating women should pay attention to the fact that the medicine can pass through the placental barrier and has no preventive effect on pregnancy-induced hypertension syndrome. Therefore, it should be used with caution by pregnant women and should not be taken by lactating women. Elderly patients are more susceptible to hypotension, electrolyte disturbances and renal impairment when taking medication.