Spironolactone/hydrochlorothiazide

Hydrochlorothiazide Spironolactone (Aldactazide) Hydrochlorothiazide Triamterene (Dyazide, Maxzide)... 

DIURETICS are in common use as antihypertensives, and often a mild diuretic may be all that is required e.g. amiloride, chlorothiazide, ethacrynic acid, fnisemide, hydrochlorothiazide, spironolactone, triamterene. 

Diuretic activity of a chloroform extract of horsetail was observed in mice. The effect of 50 mg/kg of horsetail was greater than that of the drugs hydrochlorothiazide, spironolactone, or furosemide (all 25 mg/kg) in relation to the urine output and excretion of sodium, potassium, and chloride (Perez Gutierrez et al. 1985). 

Amiloride (Midamor) is used in the treatment of CHF and hypertension and is often used with a thiazide diuretic. Spironolactone and triamterene are also used in tiie treatment of hypertension and edema caused by CHF, cirrhosis, and the nephrotic syndrome Amiloride, spironolactone, and triamterene are also available with hydrochlorothiazide, a thiazide diuretic that enhances tiie antihypertensive and diuretic effects of the drug combination while still conserving potassium. 

Hydrochlorothiazide has its proposed site of action at the distal convoluted tubule or, more specifically, at the early portion of the distal tubule. Hydrochlorothiazide inhibits the reabsorption of Na and Cl. It also promotes the reabsorption of Ca back into the blood, but inhibits the re absorption of Mg from the renal tubular fluid. The K-sparing diuretic agents (spironolactone, triamterene, and amiloride) have their site of action in the nephron at the late distal tubule and the collecting duct. These diuretic agents only cause a mild natriuretic effect... 

Hydrochlorothiazide A Spironolactone Aldactazide) [Antihypertensive/Thiazide K Sparing Diuretic] Uses Edema, HTN Action Thiazide K -sparing diuretic Dose 25-200 mg each component/d, doses Caution [D, +] Contra Sulfonamide aUa-gy Disp Tabs (HCTZ/spironolactone) 25 mg/25 mg, 50 mg/50 mg SE Photosens, X BP, t or -1-K% -1- Na% hypoglycemia, hyperlipidemia, hyperuricemia Additional Interactions t Risk of hypokalemia W/ ACEIs, K-sparing diuretics, K supls, salt substitutes -1- effects OF digoxin EMS See Hydrochlorothiazide Amiloride OD See Hydrochlorothiazide Amiloride... 

C. Trimethaphan is a ganglionic blocking agent that will lower blood pressure very rapidly. Hydralazine is a vasodilator hydrochlorothiazide and spironolactone are diuretics and methyldopa is a sympatholytic acting in the central nervous system. All of these drugs are used clinically as antihypertensive agents. None work as rapidly as trimethaphan. Clinically, however, either nitroprusside or clonidine is used much more commonly than trimethaphan in this situation. 

OFFICIAL NAMES Acetazolamide, amiloride, bendroflume-thiazide, benzthiazide, bumetanide, chlorothiazide, chlorthalidone, dichlorphenamide, dorzolamide, ethacrynic acid, flume-thiazide, furosemide, glycerin, isosorbide, hydrochlorothiazide (HCT), hydroflumethiazide, mannitol, methydothiazide, metola-zone, polythiazide, quinethazone, spironolactone, torsemide, triamterene, trichlormethiazide STREET NAMES Water pills DRUG CLASSIFICATIONS Notscheduled... 

Often, diuretics are used in combination with other drugs to relieve hypertension. Types of diuretics used to treat hypertension include thiazides, such as chlorothiazide (Diuril) and hydrochlorothiazide (Esidrex) potassium-sparing diuretics, such as spironolactone (Aldac-tone) and loop diuretics, such as furosemide (Lasix). 

A ratio-spectra, zero-crossing, derivative spectrophotometric method was described for the analysis of spironolactone in presence of hydrochlorothiazide [16]. After extracting the drugs from their tablets with 1 1 0.1 N HC1 - methanol, the first derivative of the ratio of their absorption spectra to that of standard solution is computed at 270.7 and 269.9 nm. 

Wahbi reported on the use of second-derivative spectroscopy for the determination of canrenone in spironolactone, and found that the method is stability-indicating for spironolactone [21]. First and second-derivative spectroscopy were also utilized for the simultaneous analysis of spironolactone in combination with either hydrochlorothiazide or frusemide [22], The drugs are extracted with ethanol and analyzed through the use of the zero-crossing method. Nowakowska [23] analyzed mixtures of spironolactone and hydrochlorothiazide in tablets by measuring the absorbance of all species at 239 nm, and that of hydrochlorothiazide at 318 nm. The recoveries for spironolactone were found to be 97.9 to 101.8%, with a coefficient of variation of less than 0.1%. 

A flow-injection method was reported for simultaneous determination of spironolactone and hydrochlorothiazide [60]. Samples are injected into a carrier stream of pH 5 acetate buffer, and spectra recorded from 220 - 350 nm at 1-second intervals and at an integration time of 0.4 seconds [60]. 

Actions Thiazide diuretics, such as hydrochlorothiazide [hye droe klor oh THYE a zide], lower blood pressure, initially by increasing sodium and water excretion. This causes a decrease in extracellular volume, resulting in a decrease in cardiac output and renal blood flow (Figure 19.6). With long-term treatment, plasma volume approaches a normal value, but peripheral resistance decreases. Spironolactone [spye row no LAK tone], a potassiumsparing diuretic, is often used with thiazides. (A complete discussion of diuretics is found on p. 223.)... 

Among drugs considered to be absorbed more quickly with food are carbamazepine, phenytoin, diazepam, dicoumarol, erythromycin (contentious), griseofulvin, hydralazine, hydrochlorothiazide, lithium citrate, labetalol, propranolol, metoprolol, nitrofurantoin, propoxyphene and spironolactone,... 

Aloe 2. Dandelion 3. Elder 4. Liquorice 5. Nettle 6. Rhubarb 1. Bendroflumethiazide 2. Bumetanide 3. Chlortalidone 4. Hydrochlorothiazide 5. Indapamide 6. Furosemide 7. Torasemide Low body potassium, which may give rise to lethargy and muscle weakness t potassium loss from the gut (aloe, liquorice) Possess diuretic properties (dandelion, elder, nettle, rhubarb) Avoid concomitant use. Provide potassium supplements orally. Use a potassium-sparing diuretic such as spironolactone or amiloride... 

Diuretics amiloride, bendrofluazide, benzthiazide, chlorothiazide, clopamide, cyclopenihiazide, cyclolhiazide, ethacrynic acid, frusemide, hydrochlorothiazide, polythiazide, quineth-azone, spironolactone, triamterene... 

Hyperkalemic muscle paralysis has been reported in renal insufficiency and trauma and in patients taking spironolactone and amUoride plus hydrochlorothiazide (co-amilozide). ACE inhibitors inhibit the release of aldosterone, reducing renal potassium loss, which can be enhanced by potassiumsparing diuretics or pre-existing renal insufficiency. 

Note Aldactazide is spironolactone and hydrochlorothiazide Aldoril is methyldopa and hydrochlorothiazide Avalide is irbesartan and hydrochlorothiazide Capozide is captopril and hydrochlorothiazide Dyazide is triamterene and hydrochlorothiazide Maxzide is triamterene and hydrochlorothiazide Moduretic is amiloride and hydrochlorothiazide Prinizide is lisinopril and hydrochlorothiazide... 

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