Question

Discuss the expected effects of thiazides and loop diuretics on blood glucose, lipids, uric acid, calcium and magnesium and identify the preexisting conditions that might require extra caution if these diuretics is anticipated

Answer 1

Thiazide is a type of diuretic that is used in control of hypertension it acts by inhibiting sodium and calcium ion reabsorption from DCT of kidney.  

Effect on blood glucose:-

According to several studies thiazide is responsible for causing hyperglycemia, it may worsen the diabetic situation by causing insulin resistance, imapair the glucose tolerance, inhibiting glucose uptake and decreasing release of insulin. It also activate renin , angiotensin aldosteron pathway and causes hyperglycemia.

Effect on lipid- long term thiazide therapy may increase low density lipoprotein, triglycerides, cholesterol and it worsen the situation in type II DM patients .

Effect on uric acid- thiazides increases uric acid production and decreases uric acid excretion and this way causes risk of gout .

Effect of calcium - thiazide decreases calcium reabsorption . It causes hypercalcemia in patient who is suffering from primary hyperparathyroidism.

Effect on magnesium - Thiazide causes excretion of magnesium and may cause artheremia in hypertensive patients.

Loop diuretics causes diuresis by inhibiting sodium , calcium and potassium ion reabsorption in loop of henle .

Effect on blood glucose- loop diuretic cause hyperglycemia by decreasing the rate of glucose utilization. The hyperglycemia is due to hyperkalemia.

Effect on lipid- increase lipid and lipoprotein.

Effect on magnesium- loop diuretic may decrease magnesium reabsorption in renal tubule by causing magnesium loss .and hypokalemia may devoloped in prolonged use .

Effect on calcium - loop diuretic may cause calcium loss . In long term use it may cause hypocholoremia .. and metabolic alkalosis.

Effect on uric acid - increase uric acid production and decreases uric acid excretion thus increases the chance of gout ...

PRE-EXISTING CONDITION THAT MAY REQUIRE ECTRA CAUTION IF THESE DIURETICS IS ANTICIPATED

Gout

Type II Diabetes Mellitus

Liver disease

Kidney disease

Tachycardia or Bradycardia

Hypokalemia

Age over 65 years

Allergy from these drugs..

Thank you.