Chlorthalidone Tablets

1. Effect on water and electrolyte excretion. ① Diuretic effect, increased excretion of urinary sodium, potassium, chloride, phosphorus and magnesium ions, and reduced excretion of urinary calcium. The mechanism of action of this type of drug is mainly to inhibit the reabsorption of sodium chloride in the distal tubule anterior segment and the proximal tubule (less severe), thereby increasing the Na-K exchange in the distal tubule and the collecting duct, and increasing K+ secretion. Its mechanism of action is not yet fully understood. This type of drug can inhibit carbonic anhydrase activity to varying degrees, so it can explain its effect on the proximal tubule. This type of drug can also inhibit phosphodiesterase activity, reduce the tubular uptake of fatty acids and mitochondrial oxygen consumption, thereby inhibiting the active reabsorption of Na and Cl- by the tubule. ② Antihypertensive effect. In addition to the diuretic and sodium excretion effects, there may be extrarenal mechanisms involved in antihypertensive treatment, which may be to increase the excretion of Na in the gastrointestinal tract. 2. Effect on renal hemodynamics and glomerular filtration function. Due to the decrease in renal tubular reabsorption of water and Na, the increase in renal tubular pressure, and the increase in water and Na flowing through the distal convoluted tubule, the macula densa is stimulated through the tubular-glomerular reflex, which increases the secretion of renin and angiotensin in the kidney, causing renal vasoconstriction, decreased renal blood flow, contraction of the glomerular afferent and efferent arterioles, and decreased glomerular filtration rate. The decrease in renal blood flow and glomerular filtration rate, as well as the lack of effect on the loop of Henle, are the main reasons why this type of drug has a much inferior diuretic effect to loop diuretics.

Main ingredient: Chlorthalidone. Chemical name: 5-(2,3-dihydro-1-hydroxy-3-oxo-1H-isoazaindene-1-yl)-2-chlorobenzenesulfonamide. Molecular formula: C14H11ClN2O4S Molecular weight: 338.76

1. Edema diseases, excrete excess sodium and water in the body, reduce the volume of extracellular fluid, and eliminate edema. Common ones include congestive heart failure, ascites due to liver cirrhosis, nephrotic syndrome, edema caused by acute and chronic nephritis, early stage of chronic renal failure, sodium and water retention caused by adrenocortical hormone and estrogen treatment. 2. Hypertension can be used alone or in combination with other antihypertensive drugs, mainly for the treatment of primary hypertension. 3. Central or nephrogenic diabetes insipidus. 4. Nephrolithiasis is mainly used to prevent stones formed by calcium salt components.

1 Oral dose for adults. ① For the treatment of edema, 25-50 mg each time, 1-2 times a day, or every other day, or for 3-5 consecutive days a week. ② For the treatment of hypertension, 25-100 mg per day, divided into 1-2 times, and the dose is adjusted according to the antihypertensive effect. 2 Oral dose for children. 1-2 mg/kg per day or 30-60 mg/m2 per body surface area, divided into 1-2 times, and the dose is adjusted according to the efficacy. The dose for infants under 6 months old can reach 3 mg/kg per day.

Most adverse reactions are related to the dose and course of treatment. 1. Side effects caused by water and electrolyte disorders are more common. Hypokalemia is more likely to occur, which is related to the potassium excretion effect of thiazide diuretics. Long-term potassium deficiency can damage the renal tubules. Severe potassium loss can cause vacuolar changes in the renal tubular epithelium and cause ectopic heart rates such as severe tachyarrhythmias. In hypochloremic alkalosis or hypochloremic and hypokalemic alkalosis, thiazides, especially hydrochlorothiazide, often significantly increase the excretion of chloride. In addition, hyponatremia is not uncommon, leading to central nervous system symptoms and aggravating renal damage. Dehydration causes a decrease in blood volume and renal blood flow, which can also cause a decrease in glomerular filtration rate. Common clinical reactions to the above-mentioned water and electrolyte disorders include dry mouth, thirst, muscle cramps, nausea, vomiting, and extreme fatigue and weakness. 2. Hyperglycemia. This drug can reduce glucose tolerance and increase blood sugar, which may be related to the inhibition of insulin release. 3. Hyperuricemia. Interfere with the excretion of uric acid by the renal tubules, and in some cases may induce gout attacks. Since there is usually no joint pain, hyperuricemia is easily ignored. 4. Allergic reactions, such as rash, urticaria, etc., but they are relatively rare. 5. Leukopenia or deficiency of blood cells, thrombocytopenic purpura, etc. are also rare. 6 Others, such as cholecystitis, pancreatitis, sexual dysfunction, photosensitivity, color vision disorders, etc., but they are relatively rare.

Not yet clear

1 Adrenocortical hormone, adrenocorticotropic hormone, estrogen, and amphotericin B (intravenous administration) can reduce the diuretic effect of this drug and increase the chance of electrolyte imbalance, especially hypokalemia. 2 Nonsteroidal anti-inflammatory analgesics, especially indomethacin, can reduce the diuretic effect of this drug, which is related to the former's inhibition of prostaglandin synthesis. 3 When used in combination with sympathomimetic amines, the diuretic effect is weakened. 4 Cholestyramine (cholestyramine) can reduce the gastrointestinal absorption of this drug, so this drug should be taken 1 hour before or 4 hours after oral cholestyramine. 5 When used in combination with dopamine, the diuretic effect is enhanced. 6 When used in combination with antihypertensive drugs, the diuretic and antihypertensive effects are enhanced. 7 When used in combination with anti-gout drugs, the latter should adjust the dose. 8 The effect of anticoagulants is weakened, mainly because the body's plasma volume decreases after diuresis, the level of coagulation factors in the blood increases, and diuresis improves the blood supply to the liver and increases the synthesis of coagulation factors. 9 Reduce the effect of hypoglycemic drugs. 10 When digitalis drugs, amiodarone, etc. are used in combination with this drug, side effects caused by hypokalemia should be prevented. 11 When used in combination with lithium preparations, this drug can reduce the kidney's clearance of lithium and increase lithium nephrotoxicity. 12 When hexamethylenetetramine is used in combination with this drug, its conversion to formaldehyde is inhibited and the efficacy is reduced. 13 It enhances the effect of non-depolarizing muscle relaxants and is related to the decrease in blood potassium. 14 When used in combination with sodium bicarbonate, the chance of hypochloremic alkalosis increases.

Keep away from light and store in sealed container.

100mg

China Resources Double-Crane Pharmaceutical Co., Ltd.

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  1997-05-16

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