Chlorothiazide

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Chlorothiazide
Systematic (IUPAC) name
6-chloro-2H-1,2,4-benzothiadiazine-7-sulfonamide 1,1-dioxide
Identifiers
CAS number	58-94-6
ATC code	C03AA04
PubChem	2720
DrugBank	APRD00721
Chemical data
Formula	C7H6ClN3O4S2
Mol. mass	295.725 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	Nil
Half life	45 to 120 minutes
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	C(US)
Legal status	℞-only(US)
Routes	Oral

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Chlorothiazide sodium (Diuril) is a diuretic used within the hospital setting or for personal use to manage excess fluid associated with congestive heart failure. It is also used as an antihypertensive.

Most often taken in pill form, it is usually taken orally once or twice a day. In the ICU setting, chlorothiazide is given to diurese a patient in addition to furosemide (Lasix). Working in a separate mechanism than furosemide, and absorbed enterically as a reconstituted suspension administered through a nasogastric tube (NG tube), the two drugs potentiate one another without risk of toxicity. Because it is absorbed enterically there are no risks associated with chlorothiazide as there are with furosemide administration.

Indications

• Large amount of excess fluid including:
  • Diagnosed congested heart failure
  • Peripheral edema
  • Rales / Rhonchi
  • Hypertension

Contraindications

• Renal failure or insufficency
• Allergies to sulfa drugs

Dose

• 500 mg–1 g once or twice a day, by mouth or through NG tube (reconstituted suspension)
• May also be given intravenously, and should be given first if given in combination with IV lasix since it potentiate's the diuretic effect of furosemide.

Side effects

• Nausea / Vomiting
• Headache
• Dizziness
• Excess urine production
• Dehydration
• Hypoelectrolytemia (esp. hypokalemia / hypomagnesia)

v • d • e Antihypertensives (C02) and diuretics (C03)
Sympatholytic agents	Centrally acting/antiadrenergics α2 agonist (Clonidine, Guanfacine, Methyldopa) imidazoline receptor agonist (Moxonidine, Rilmenidine) adrenergic uptake inhibitor (Rescinnamine, Reserpine) Ganglion-blocking/nicotinic antagonist Mecamylamine, Trimethaphan Peripherally acting/antiadrenergics Alpha blockers: Prazosin • Indoramin • Trimazosin • Doxazosin • Urapidil Guanidine derivatives: Betanidine • Guanethidine • Guanoxan • Debrisoquine • Guanoclor • Guanazodine • Guanoxabenz
Vasodilators	Diazoxide • hydrazinophthalazine (Hydralazine, Dihydralazine, Endralazine, Cadralazine) • Minoxidil • Nitroprusside • Phentolamine
Other antihypertensives	serotonin antagonist (Ketanserin) • endothelin receptor antagonist (Bosentan, Ambrisentan, Sitaxsentan) • MAOI (Pargyline) • THI (Metirosine)
Diuretics	Low ceiling Thiazides Bendroflumethiazide • Hydroflumethiazide • Hydrochlorothiazide • Chlorothiazide • Polythiazide • Trichlormethiazide • Cyclopenthiazide • Methyclothiazide • Cyclothiazide • Mebutizide Sulfonamides Quinethazone • Clopamide • Chlortalidone • Mefruside • Clofenamide • Metolazone • Meticrane • Xipamide • Indapamide • Clorexolone • Fenquizone Other Mersalyl • Theobromine • Cicletanine High ceiling Loop diuretic (Bumetanide, Furosemide, Torsemide) Potassium-sparing ESC blockers (Amiloride, Triamterene) • aldosterone antagonists (Spironolactone, Eplerenone, Potassium canrenoate, Canrenone)

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

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