Chlorothiazide Explained

Chlorothiazide, sold under the brand name Diuril among others, is an organic compound used as a diuretic and as an antihypertensive.^{[1] [2]}

It is used both within the hospital setting or for personal use to manage excess fluid associated with congestive heart failure. Most often taken in pill form, it is usually taken orally once or twice a day. In the ICU setting, chlorothiazide is given to diurese a patient in addition to furosemide (Lasix). Working in a separate mechanism from furosemide and absorbed enterically as a reconstituted suspension administered through a nasogastric tube (NG tube), the two drugs potentiate one another.

It was patented in 1956 and approved for medical use in 1958.^[3] It is on the World Health Organization's List of Essential Medicines.^[4]

Indications

• Large amount of excess fluid including:
  • Heart failure
  • Peripheral edema
  • Hypertension

Contraindications

• Anuria^[5]
• Allergies to sulfa drugs

Side effects

• Nausea / Vomiting
• Headache
• Dizziness
• Excess urine production
• Dehydration
• Hypoelectrolytemia (esp. hypokalemia / hypomagnesia)

History

The research team of Merck Sharp and Dohme Research Laboratories of Beyer, Sprague, Baer, and Novello created a new series of medications, the thiazide diuretics, which includes chlorothiazide. They won an Albert Lasker Special Award in 1975 for this work.^[6]

The structure has been determined by X-ray crystallography.^[7]

See also

• Hydrochlorothiazide

Notes and References

1. Ernst ME, Grimm J, Richard H . Thiazide diuretics: 50 years and beyond. . Current Hypertension Reviews . November 2008 . 4 . 4 . 256–65 . 10.2174/157340208786241264 .
2. Duarte JD, Cooper-DeHoff RM . Mechanisms for blood pressure lowering and metabolic effects of thiazide and thiazide-like diuretics . Expert Review of Cardiovascular Therapy . 8 . 6 . 793–802 . June 2010 . 20528637 . 2904515 . 10.1586/erc.10.27 .
3. Book: Fischer J, Ganellin CR . Analogue-based Drug Discovery . 2006 . John Wiley & Sons . 9783527607495 . 456 . en.
4. Book: ((World Health Organization)) . World Health Organization model list of essential medicines: 22nd list (2021) . 2021 . 10665/345533 . World Health Organization . World Health Organization . Geneva . WHO/MHP/HPS/EML/2021.02 . free .
5. Web site: Diuril (Chlorothiazide): Side Effects, Interactions, Warning, Dosage & Uses. RxList. en. 2019-10-07.
6. Web site: Historical Awards - The Lasker Foundation . The Lasker Foundation.
7. Johnston A, Bardin J, Johnston BF, Fernandes P, Kennedy AR, Price SL, Florence AJ . 10.1021/cg1010049 . Experimental and Predicted Crystal Energy Landscapes of Chlorothiazide . 2011 . Crystal Growth & Design. 11. 2. 405–413.