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μμ© κΈ°μ : Chlorothiazide acts primarily on the **distal convoluted tubule (DCT)** of the nephron. * **Primary Mechanism:** Inhibits the **NaβΊ/Clβ» symporter** in the luminal membrane of the DCT β prevents reabsorption of sodium and chloride β promotes osmotic diuresis. * **Electrolyte Effects:** Enhances excretion of sodium, chloride, potassium, magnesium, phosphate, iodide, and bromide. * **Calcium Sparing:** Unlike loop diuretics, thiazides *decrease* urinary calcium excretion with chronic use, making them useful for preventing calcium oxalate uroliths. * **Hemodynamic Effects:** Decreases glomerular filtration rate (GFR). The resulting volume depletion activates the renin-angiotensin-aldosterone system (RAAS), which contributes to downstream potassium wasting (hypokalemia).
λλ¬Ό μ’ λ³ μ©λ
- Treatment of diabetes insipidus Β· 20-40 mg/kg Β· PO Β· q12h Β· May be tried
- As a diuretic Β· 20-40 mg/kg Β· PO Β· q12h Β· Twice daily
- General dosing for adult cattle Β· 4-8 mg/kg Β· PO Β· once or twice daily
- General dosing Β· 2 g Β· PO Β· once to twice daily
- Treatment of nephrogenic diabetes insipidus Β· 20-40 mg/kg Β· PO Β· q12h
- Treatment of systemic hypertension Β· 20-40 mg/kg Β· PO Β· q12-24h Β· Use with dietary salt restriction
- As a diuretic Β· 20-40 mg/kg Β· PO Β· q12h Β· Twice daily
μ©λμ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μ°Έκ³ μλ£μ λλ€. νμ μ΅μ λΌλ²¨κ³Ό κ°λ³ νμμ λν΄ νμΈνμμμ€.
ν¬μ¬ κ²½λ‘
κΈκΈ°
- Hypersensitivity to thiazides or sulfonamides
- Anuria
- Pregnancy in otherwise healthy females with only mild edema (relative contraindication)
μ΄μλ°μ
- Hypokalemia
- Hypochloremic alkalosis
- Dilutional hyponatremia
- Hypomagnesemia
- Hypercalcemia
- Hypophosphatemia
- Hyperuricemia
- Gastrointestinal distress (vomiting, diarrhea)
- Pancreatitis
- Hypersensitivity / dermatologic reactions
- Polyuria
- Hematologic toxicity
- Hyperglycemia
- Hyperlipidemias
- Orthostatic hypotension
μ½λ¬Ό μνΈμμ©
- Amphotericin B Β· Increased risk for severe hypokalemia
- Corticosteroids / Corticotropin Β· Increased risk for severe hypokalemia
- Diazoxide Β· Increased risk for hyperglycemia, hyperuricemia, and hypotension
- Digitalis / Digoxin Β· Thiazide-induced hypokalemia, hypomagnesemia, and/or hypercalcemia may increase the likelihood of digitalis toxicity
- Insulin Β· Thiazides may increase insulin requirements
- Lithium Β· Thiazides can increase serum lithium concentrations
- Methenamine Β· Thiazides can alkalinize urine and reduce methenamine effectiveness
- NSAIDs Β· May increase risk for renal toxicity; NSAIDs may reduce diuretic actions of thiazides
- Neuromuscular blocking agents Β· Response or duration of nondepolarizing agents (e.g., tubocurarine) may be increased
- Probenecid Β· Blocks thiazide-induced uric acid retention
- Quinidine Β· Half-life may be prolonged by thiazides due to urine alkalinization
- Vitamin D or Calcium Salts Β· Hypercalcemia may be exacerbated
λͺ¨λν°λ§
- Serum electrolytes (especially potassium)
- BUN and Creatinine
- Blood glucose
- Hydration status
- Blood pressure (if indicated)
- Hemograms (if indicated)
κ³Όμ©λ
Acute overdosage may cause **electrolyte and water balance problems**, CNS effects (ranging from lethargy to coma and seizures), and GI effects (hypermotility, GI distress). Transient increases in BUN have also been reported. **Treatment:** * Empty the gut after recent oral ingestion using standard protocols. * **Avoid concomitant cathartics** as they may exacerbate fluid and electrolyte imbalances. * Monitor and treat electrolyte and water balance abnormalities supportively. * Monitor respiratory, CNS, and cardiovascular status; provide symptomatic and supportive care as required.
VetSheet μ½λ¬Ό λ νΌλ°μ€λ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μμ¬κ²°μ 보쑰 λꡬμ΄λ©°, μ λ¬Έμ νλ¨μ΄λ μ μ‘°μ¬μ μ΅μ λΌλ²¨μ λμ νμ§ μμ΅λλ€.