Nurses Compass
Drug Guide
Chlorothiazide Sodium
Classification
Therapeutic: Diuretic, antihypertensive
Pharmacological: Thiazide diuretic
FDA Approved Indications
- Hypertension
- Edematous states associated with congestive heart failure, cirrhosis of the liver, or renal disease
Mechanism of Action
Chlorothiazide inhibits sodium reabsorption in the distal tubules of the nephron, leading to increased excretion of sodium, chloride, water, and some potassium, thereby reducing blood volume and blood pressure.
Dosage and Administration
Adult: Initial dose typically 250-500 mg once daily or in divided doses. Dose may be adjusted based on response.
Pediatric: Use is based on weight and medical condition; consult specific pediatric dosing guidelines.
Geriatric: Start with lower doses due to increased sensitivity and risk of dehydration or electrolyte imbalance.
Renal Impairment: Use with caution; dose adjustment may be necessary, and benefits should be weighed carefully.
Hepatic Impairment: Use with caution; monitor for alterations in response.
Pharmacokinetics
Absorption: Well absorbed from gastrointestinal tract.
Distribution: Bound to plasma proteins, distributed widely.
Metabolism: Not significantly metabolized.
Excretion: Primarily excreted unchanged in urine.
Half Life: Approx. 6-15 hours, varies with renal function.
Contraindications
- Hypersensitivity to thiazides or sulfonamide-derived drugs
- Anuria
Precautions
- Electrolyte disturbances (hypokalemia, hyponatremia, hypomagnesemia), dehydration, hypersensitivity reactions, gout, diabetes mellitus; use with caution in elderly and patients with renal or hepatic impairment.
Adverse Reactions - Common
- Electrolyte imbalance (hypokalemia, hyponatremia) (Common)
- Dizziness, hypotension (Common)
- Gastrointestinal disturbances (Common)
Adverse Reactions - Serious
- Jaundice, pancreatitis, blood dyscrasias, hypersensitivity reactions (rare) (Rare)
Drug-Drug Interactions
- Other antihypertensives, lithium, corticosteroids, NSAIDs
Drug-Food Interactions
- None significant
Drug-Herb Interactions
- None well-established
Nursing Implications
Assessment: Monitor blood pressure, electrolyte levels, renal function, hydration status.
Diagnoses:
- Risk for electrolyte imbalance
- Risk for hypotension
- Fluid volume deficit
Implementation: Administer with food to decrease gastrointestinal upset, monitor electrolytes regularly, assess for signs of dehydration.
Evaluation: Assess blood pressure response, electrolyte levels; adjust dose as needed.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Report symptoms of electrolyte imbalance (muscle weakness, cramps), dizziness, or unusual bleeding.
- Maintain adequate hydration; limit alcohol and salt intake as advised.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: None specific to this drug.
Lab Test Interference: May cause changes in serum electrolyte levels, glucose, and uric acid.
Overdose Management
Signs/Symptoms: Severe electrolyte imbalance, dehydration, hypotension, dizziness.
Treatment: Discontinue drug, provide supportive care, correct electrolyte imbalances, and maintain hydration.
Storage and Handling
Storage: Store at room temperature, 20-25°C (68-77°F).
Stability: Stable under recommended storage conditions.