Drug-Drug:qrisk of hypokalemia with thiazide and loop diuretics, ampho- ... Dexamethasone Suppression Test: To diagnose Cushing’s syndrome, ... amphotericin B colloidal, calcium chloride, calcium gluconate,caspofungin,cefuroxime,chlorpormazine,ciprofloxacin,dantrolene, Most of the blood pressure-lowering mechanistic studies are small, in vitro projects using animal rather than human tissue, and many are more than 20 years old. How these effects occur is related to the mechanisms of sodium, chloride, and calcium transport in the different diuretic-sensitive segments. Erythema multiforme, Stevens-Johnson syndrome, exfoliative dermatitis (including toxic epidermal necrolysis), and alopecia have been reported in rare cases.Gastrointestinal problems include diarrhea, vomiting, constipation or abdominal pain in approximately 5% of patients. Thiazide Diuretics. Thiazides enhance calcium (Ca) reabsorption in the distal convoluted tubule, by increasing Na/Ca exchange (which makes thiazides useful in treating the calcium-subtype of kidney stones). However, certain patients--either because they’re elderly, have comorbid conditions, or simply refuse to consider surgery—need another treatment option. Remedy The theory that all thiazides do not have a similar efficacy or mechanism of action would help explain the conflicting findings in many studies investigating their blood pressure-lowering and metabolic effects, and has been addressed previously by others Using chlorothiazide with other drugs that make you dizzy can worsen this effect. And how do loop diuretics increase the excretion of calcium through urine?" In light of these results, the scientists concluded that thiazide appeared effective at the standard daily dose of 12.5 mg and would be safe at doses up to 50 mg per day. Use of this website is This information is not designed to replace a physician's independent judgment about the appropriateness or conditional upon your acceptance of our user agreement.Endocrine Web is a Remedy Health Media, LLC web property.J Clin Endocr Metab. Eric S. Orwoll, in Osteoporosis in Men (Second Edition), 2010. “It’s the best option,” he said. Am J Physiol Renal Physiol . Calcium excretion is increased by loop diuretics and diminished by thiazide-type diuretics and amiloride. Inhibition of this cotransporter lowers intracellular Na, which in turn results in a lowering of intracellular calcium mediated by Na/Ca exchange expressed on the basolateral membrane. Rare cases of allergic interstitial nephritis have been associated with chlorothiazide.Endocrinologic changes associated with chlorothiazide, as with other thiazide diuretic agents, include decreased glucose tolerance and a potentially deleterious effect on the lipid profile. More recently non-benzothiazide drugs with a similar mechanism of action have been developed (metolazone, indapamide), which are referred to as thiazide-like diuretics. “There are still plenty of other reports out there--in every textbook--that [thiazides] can cause problems.”Dr. Isaacs advocated that endocrinologists consider the following for their PHPT patients:Always consider surgery first. Dr. Isaacs said he’d only consider prescribing thiazides to patients who absolutely could not have surgery for medical reasons.Carefully monitor urine and blood calcium levels if prescribing thiazides. “This study was prompted by the controversy surrounding the use of thiazide in patients with PHPT,” wrote the authors in the study’s discussion section.Out of 11 patients in the study whose calcium levels already were elevated at the start (11.5mg/dL or higher), nine patients experienced a decrease after receiving thiazide treatment, while 2 saw their blood calcium levels increase and required surgery at a later date.Among the 60 patients whose blood calcium level was lower than 11.5 mg/dL at the start of the study, only 8 experienced a rise in blood calcium while on In light of these results, the scientists concluded that thiazide appeared effective at the standard daily dose of 12.5 mg and would be safe at doses up to 50 mg per day.Thiazide therapy may be a good alternative to surgery for 2 particular subsets of patientsHowever, the authors urge caution due to the experience of 2 patients who started with a high blood calcium level and whose calcium levels rose even higher during treatment.