Chlorothiazide

Chlorothiazide sodium (Diuril) is a diuretic used within the hospital setting or for personal use to manage excess fluid associated with congestive heart failure. It is also used as an antihypertensive.

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 than furosemide, and absorbed enterically as a reconstituted suspension administered through a nasogastric tube (NG tube), the two drugs potentiate one another without risk of toxicity. Because it is absorbed enterically there are no risks associated with chlorothiazide as there are with furosemide administration.

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Indications

• Large amount of excess fluid including:
  • Diagnosed congested heart failure
  • Peripheral edema
  • Rales / Rhonchi
  • Hypertension

Contraindications

• Renal failure or insufficency
• Allergies to sulfa drugs

Dose

• 500 mg–1 g once or twice a day, by mouth or through NG tube (reconstituted suspension)
• May also be given intravenously, and should be given first if given in combination with IV lasix since it potentiate's the diuretic effect of furosemide.

Side effects

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