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Hydrochlorothiazide: Blood chemistry effects

Hydrochlorothiazide is a thiazide class diuretic that works by inhibiting the kidney’s ability to retain water. It is also thought to directly decrease peripheral vascular resistance via another mechanism.

Specifically, thiazidesinhibit sodium reabsorptionat the distal convoluted tubule, promoting naturesis and water loss. Like loop diuretics (which block reabsorption in the ascending tubule)potassium excretion is increased. Thiazides alsopromote calcium reabsorptionat the same site via an unrelated mechanism. Since calcium and magnesium are opposing cations in the plasma, you can gethypomagnesia.

Thiazide diuretics also decrease glucose tolerance for unclear reasons, perhaps due to reduced insulin secretion.Hyperglycemia occursand is reduced when K+ supplementation is given with a thiazide.

Thiazides mayincrease LDL cholesterol levels, total cholesterol, and triglycerides.

Effect of Hydrochlorothiazide

  • Decreased:sodium, potassium, magnesium
  • Increased: calcium,glucose, LDL, TC, TG