Are Thiazides or Loops safe in Gout?
No. Both causes hyperuricemia. Diuretic safe in gout patient are:
- Tienilic acid (INN and BAN) or
Are Thiazides or Loops safe in severely impaired renal functions?
No. Loop and thiazide diuretics increase potassium loss in the urine. These diuretics are particularly effective for patients with normal to moderately impaired kidney function.
* Thiazide-type diuretics are considered first-line agents in hypertension management due to their efficacy and positive effects on cvs and all-cause mortality.
* The antihypertensive efficacy of thiazide diuretics is reduced by the concurrent use of NSAIDs, including COX-2 inhibitors.
* Thiazides + Lithium: Lithium levels can increase by as much as 40% with the introduction of a thiazide diuretic, potentially resulting in lithium toxicity. Keep in mind that Lithium is fully excreted by the kidneys and there is no liver involvement.
* Loop diuretic–induced renal insufficiency, hypokalemia, and hypomagnesemia can precipitate digitalis toxicity
* One significant difference between the two drug groups is loop diuretics promote renal calcium excretion, which can potentially promote nephrolithiasis. Loops cause hypocalcemia and Thiazides cause hypercalcemia.
This topic is important for many national and state exams and hence rated a must read.