ABSTRACT
O potássio tem função fisiológica fundamental no volume intracelular e na manutenção funcional de nervos e músculos. Distúrbios do potássio são comuns e estão associados a aumento na mortalidade nos portadores de doenças cardiovasculares, entre elas a hipertensão arterial. Assim a manutenção de um equilíbrio entre o potássio intra e extracelular é de fundamental importância para nervos, músculos e o sistema cardiovascular. Há décadas os diuréticos tiazídicos são uma das principais drogas utilizadas no tratamento da hipertensão arterial. Entre suas principais reações adversas relacionam-se os distúrbios eletrolíticos e metabólicos, os quais se tornaram menos frequentes com o uso de doses menores do que as habitualmente empregadas no seu início. Neste artigo os principais efeitos adversos do uso crônico dos diuréticos tiazídicos bem como suas consequências serão discutidos.
Potassium has a fundamental physiological function without intracellular volume and in the functional maintenance of nerves and muscles. Potassium disorders are common and are associated with increased mortality in patients with cardiovascular diseases, including hypertension. Thus, maintaining a balance between intracellular and extracellular potassium is of fundamental importance for the nerves, muscles and cardiovascular system. Thiazide diuretics have been one of the main drugs used in the treatment of hypertension for decades. Among its main adverse reactions are related electrolyte and metabolic disturbances, which become less frequent with the use of lower doses than those usually used at the beginning. In this article, the main adverse effects of the chronic use of thiazide diuretics as well as their consequences will be discussed.
Subject(s)
Humans , Sodium Chloride Symporter Inhibitors/adverse effects , HypokalemiaABSTRACT
In Chile, hydrochlorothiazide is frequently prescribed as first line antihypertensive therapy. Among it’s well known adverse reactions are: electrolytic disorders, hyperuricemia, dyslipidemia, agranulocytosis and azotemia. Acute pulmonary edema is a rare and potentially lethal adverse effect. Only 50 cases have been reported since 1968. In this article, we discuss a case of a 70 year old woman who, one hour after the ingestion of hydrochlorotiazide, presented acute and progressive dyspnea. Her clinical and radiologic findings are compatible with non-cardiogenic acute pulmonary edema.
En Chile, la hidroclorotiazida se utiliza ampliamente como terapia de primera línea en la hipertensión arterial esencial. Entre los efectos adversos más conocidos destacan: trastornos hidroelectrolíticos, hiperuricemia, dislipidemia, azotemia, entre otros. El edema pulmonar agudo es un efecto adverso infrecuente y potencialmente grave. Desde 1968, se han reportado 50 casos clínicos en la literatura. En este artículo presentamos el caso clínico de una mujer de 70 años atendida en el Hospital Santiago Oriente quien, una hora posterior a la ingesta de hidroclorotiazida, presenta disnea aguda progresiva. El estudio clínico y radiológico es compatible con edema pulmonar agudo no cardiogénico.
Subject(s)
Humans , Female , Aged , Pulmonary Edema/chemically induced , Diuretics/adverse effects , Hydrochlorothiazide/adverse effects , Pulmonary Edema/diagnostic imaging , Tomography, X-Ray Computed/methods , Acute Disease , Sodium Chloride Symporter Inhibitors/adverse effects , Intensive Care UnitsSubject(s)
Benzothiadiazines , Bronchodilator Agents/adverse effects , Diseases in Twins , Diuretics , Humans , Hyponatremia/chemically induced , Inappropriate ADH Syndrome/chemically induced , Infant, Newborn , Respiration, Artificial , Respiratory Distress Syndrome, Newborn/drug therapy , Sodium Chloride Symporter Inhibitors/adverse effects , Theophylline/adverse effectsABSTRACT
La hiponatremia es un disturbio hidroelectrolítico frecuente entre pacientes internados; y su presencia está asociada a un incremento en la mortalidad. Las tiazidas, que son drogas ampliamente usadas en el tratamiento de la hipertensión arterial, son una causa infrecuente de hiponatremia severa. El caso presentado ejemplifica una hiponatremia euvolémica grave, donde se establecen llaves diagnosticas para dilucidar la causa del estado hiponatrémico
Subject(s)
Humans , Female , Aged , Hyponatremia/etiology , Sodium Chloride Symporter Inhibitors/adverse effects , Hyponatremia/physiopathologySubject(s)
Humans , Aged , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Adrenergic Antagonists/therapeutic use , Antihypertensive Agents/therapeutic use , Calcium Channel Blockers/therapeutic use , Hypertension/drug therapy , Sympatholytics/therapeutic use , Sodium Chloride Symporter Inhibitors/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Adrenergic Antagonists/adverse effects , Antihypertensive Agents/adverse effects , Calcium Channel Blockers/adverse effects , Hypertension, Malignant/drug therapy , Hypertension/complications , Hypertension/diagnosis , Hypertension/therapy , Sympatholytics/adverse effects , Sodium Chloride Symporter Inhibitors/adverse effects , Vasodilator Agents/therapeutic useABSTRACT
En este trabajo se realizó una revisión de los principales grupos de diuréticos, sus sitios y mecanismos de acción y sus efectos sobre las pruebas de laboratorio. Se analizó el efecto de los diuréticos sobre: el estado ácido base, los electrolitos séricos y urinarios, el ácido úrico sérico y urinario y sobre la glucemia. También se describió la influencia de los diuréticos sobre los análisis de orina. Finalmente, los efectos hematológicos de los mismos. El objetivo de este trabajo fue estudiar la influencia de los diuréticos en los análisis clínicos, buscando los mecanismos fisiopatológicos o metodológicos de los casos citados