Thiazide diuretics on the NCLEX
HCTZ and the thiazide class for NCLEX: first-line HTN, K+ loss, glucose, gout.
Thiazides act on the distal tubule. Less potent than loops but well-tolerated. First-line for HTN per most guidelines.
Common drugs
Hydrochlorothiazide (HCTZ), chlorthalidone, metolazone (more potent, often added to loop in severe HF).
Action and use
Block Na reabsorption in distal tubule. Modest diuresis. First-line antihypertensive. Used in CHF, edema.
Side effects
Hypokalemia, hyponatremia, hypercalcemia, hyperglycemia, hyperuricemia (gout). Sulfa allergy concern.
Teaching
Take in morning. Increase K+-rich foods or supplement. Monitor blood glucose in diabetics. Watch for gout flare.
Frequently asked
Why hyperglycemia?
Thiazides impair insulin release and increase insulin resistance. Modest effect, but matters in diabetics.
Stop in gout?
Often switched if gout flares are recurrent. Loop diuretics also raise urate.
Quick check
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