Hydrochlorothiazide: Mechanism of Action, Monitoring, and Side Effects
Lorraine is a 64-year-old African American female who has been monitoring her blood pressure at home. She brings a log of home readings with the following ranges: 150-222/102-88. Her blood pressure in the office today is 160/92. She has her BP monitor with her and the reading on the monitor is similar to today's office reading. She states that she has swelling in both ankles at night, but the swelling usually resolves overnight. She wears compression hose at work as she is on her feet for most of her 10-hour shift. She has no comorbid conditions and no known allergies at present . Her mother and sister have hypertension and encouraged Lorraine to seek care.
Initial treatment of an African American patient will be lifestyle changes and a diuretic. Choose a diuretic and discuss the mechanism of action, monitoring, and side effects. In addition, share a time when the use of this medication resulted in a positive or negative outcome in a patient for whom you were caring. Discuss evidence and treatment guidelines to determine appropriate therapeutic options for this patient. Include the name of the medication in the subject line so that the medications can be followed. Include references using APA format.
T5 DQ1
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Case Study
The first-line treatment for the patient described for her hypertension is a thiazide diuretic such as hydrochlorothiazide. It inhibits the reabsorption of sodium by the renal tubule, which leads to urinary excretion of sodium; it also acts in the excretion of chlorides and potassium. This will increase diuresis, decreasing high blood pressure (Zilbermint et al., 2019). The increase in diuresis will result clinically in the reduction or disappearance of bilateral ankle swelling. Monitoring a patient on hydrochlorothiazide will be both clinical and complementary tests. It will include antihypertensive action, improvement in the initial signs, side effects, and complications mainly by the dosage of electrolytes, and renal and cardiac functions assessment.
The side effects of the drug will include, as per its action mechanism, electrolyte imbalances, including hyponatremia, hypokalemia, hypocalcemia, and hypomagnesemia. The drug is also known to cause hyperlipidemia and hyperuricemia (Zilbermint et a...
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