DIURETICS-THIAZIDE DIURETICS

SUMMARY

1. Inhibits only 3 to 5% of sodium reabsorption.

2. Inhibit the Na/CI co-transporter in the early distal tubule.

3. Increase delivery of Na⁺ to the early distal tubule and up-regulation of the counter-transport of the Na/K ATPase, leading to hypokalemia.

4. Inhibit dilution of urine (main site in DCT): excess loss of electrolytes as compared to water excretion.

5. Thiazides actually increase calcium reabsorption, which is in contrast with the action of loop diuretics - avoid in primary hyperparathyroidism or hypercalcemia of malignancy.

6. Thiazides can be useful in reducing urinary calcium in patients with kidney stones.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].