Thiazide

Benzothiadiazine, the parent structure of this class of molecules
Chlorothiazide, the first thiazide drug
Illustration of the mechanism of action of thiazide diuretics in the distal convoluted tubule of nephrons.

Thiazide refers to both a class of sulfur-containing organic molecules and a class of diuretics based on the chemical structure of benzothiadiazine.

- Thiazide

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Diuretic

Any substance that promotes diuresis, the increased production of urine.

Furosemide 125mg vials for intravenous application

The antihypertensive actions of some diuretics (thiazides and loop diuretics in particular) are independent of their diuretic effect.

Kidney stone disease

Crystallopathy where a solid piece of material develops in the urinary tract.

A kidney stone, 8 mm in diameter
Diagram showing the typical location of renal colic, below the rib cage to just above the pelvis
A kidney stone (yellow) composed of calcium oxalate
Small crystals formed in the kidney. The most common crystals are made of calcium oxalate and they are generally 4–5 mm. Staghorn kidney stones are considerably larger. 1. Calcium and oxalate come together to make the crystal nucleus. Supersaturation promotes their combination (as does inhibition.) 2. Continued deposition at the renal papillae leads to the growth of the kidney stones. 3. Kidney stones grow and collect debris. In the case where the kidney stones block all routes to the renal papillae, this can cause extreme discomfort and pain. 4. The complete staghorn stone forms and retention occurs. Smaller solids that break off can become trapped in the urinary glands causing discomfort. 5. Displaced stones travel through the ureter. If they cannot be broken down, they must be physically removed by a surgeon.
Struvite crystals found on microscopic examination of the urine
Scanning electron micrograph of the surface of a kidney stone showing tetragonal crystals of Weddellite (calcium oxalate dihydrate) emerging from the amorphous central part of the stone (the horizontal length of the picture represents 0.5 mm of the figured original)
Multiple kidney stones composed of uric acid and a small amount of calcium oxalate
A lenticular kidney stone, excreted in the urine
Illustration of kidney stones
Radiograph showing a large staghorn calculus involving the major calyces and renal pelvis in a person with severe scoliosis
A lithotriptor machine with a mobile fluoroscopic system ("C-arm") is seen in an operating room; other equipment is seen in the background including an anesthesia machine.
Urolithiasis deaths per million persons in 2012
Bilateral kidney stones can be seen on this KUB radiograph. There are phleboliths in the pelvis, which can be misinterpreted as bladder stones.
Axial CT scan of abdomen without contrast, showing a 3-mm stone (marked by an arrow) in the left proximal ureter
Renal ultrasonograph of a stone located at the pyeloureteric junction with accompanying hydronephrosis.
Measurement of a 5.6 mm large kidney stone in soft tissue versus skeletal CT window.

If this is not effective enough, thiazide diuretic, citrate, or allopurinol may be taken.

Distal convoluted tubule

Portion of kidney nephron between the loop of Henle and the collecting tubule.

Kidney nephron ("1st proximal convoluted tubule", "2nd distal convoluted tubule")
1 Glomerulus, 2 proximal tubule, 3 distal tubule
Transverse section of pyramidal substance of kidney of pig, the bloodvessels of which are injected.
Renal corpuscle
Diagram outlining movement of ions in nephron.

Thiazide diuretics inhibit Na+/Cl− reabsorption from the DCT by blocking the thiazide-sensitive Na-Cl cotransporter.

Merck & Co.

American multinational pharmaceutical company headquartered in Rahway, New Jersey.

Gardasil in Japanese packaging (showing the MSD branding)
The Angel Pharmacy in Darmstadt, the beginning of the Merck Group
Merck Research Laboratories in South San Francisco, California

In the 1950s, thiazide diuretics were developed by Merck scientists Karl H. Beyer, James M. Sprague, John E. Baer, and Frederick C. Novello and led to the marketing of the first drug of this class, chlorothiazide, under the trade name Duiril in 1958.

Hydrochlorothiazide

Diuretic medication often used to treat high blood pressure and swelling due to fluid build up.

Co-Diovan (valsartan and HCTZ)
Two generic benazepril HCl 20 mg and HCTZ 25 mg oral tablets

It is in the thiazide medication class and acts by decreasing the kidneys' ability to retain water.

Antihypertensive drug

Antihypertensives are a class of drugs that are used to treat hypertension (high blood pressure).

Hydrochlorothiazide, a popular thiazide diuretic
Captopril, the prototypical ACE inhibitor
Valsartan, an angiotensin II receptor antagonist
Propranolol, the first beta-blocker to be successfully developed

Among the most important and most widely used medications are thiazide diuretics, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists (ARBs), and beta blockers.

Hypokalemia

Low level of potassium in the blood serum.

An ECG in a person with a potassium level of 1.1 meq/L showing the classical changes of ST segment depression, inverted T waves, large U waves, and a slightly prolonged PR interval.

Certain medications can cause excess potassium loss in the urine. Blood pressure medications such as loop diuretics (e.g. furosemide) and thiazide diuretics (e.g. hydrochlorothiazide) commonly cause hypokalemia. Other medications such as the antifungal amphotericin B or the cancer drug cisplatin can also cause long-term hypokalemia. Diuretic abuse among athletes and people with eating disorders may present with hypokalemia due to urinary potassium loss.

Type 2 diabetes

Form of diabetes that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.

A blue circle is the universal symbol of diabetes
Overview of the most significant symptoms of diabetes
Metformin 500 mg tablets
Regional rates of diabetes using data from 195 countries in 2014

Some of the medications include: glucocorticoids, thiazides, beta blockers, atypical antipsychotics, and statins.

Hyperglycemia

Condition in which an excessive amount of glucose circulates in the blood plasma.

White hexagons in the image represent glucose molecules, which are increased in the lower image.
Group aerobic exercises
Replacing white bread with whole wheat may help reduce hyperglycemia

Certain medications increase the risk of hyperglycemia, including: corticosteroids, octreotide, beta blockers, epinephrine, thiazide diuretics, statins, niacin, pentamidine, protease inhibitors, L-asparaginase, and antipsychotics.

Hyperlipidemia

Abnormally elevated levels of any or all lipids or lipoproteins in the blood.

A 4-ml sample of hyperlipidemic blood in a vacutainer with EDTA. Left to settle for four hours without centrifugation, the lipids separated into the top fraction.
Relative prevalence of familial forms of hyperlipoproteinemia

Use of drugs such as thiazide diuretics, beta blockers, and estrogens