Pritor Plus

Brand Name: Pritor plus Generic Name: Hydrochlorothiazide Indication: Edema, Hypertension Drug Classification: Antihypertensive (angiotension II antagonist with diuretic) Mechanism of Action: A thiazide diuretic that increases sodium by inhibiting sodium and chloride reabsorption in distal segment of the nephron. Dosage: Edema – Adults: 25 to 100 mg P.O daily or intermittently; up to 200 mg initially for several days until dry weight is attained. Hypertension – Adults: 12.5 to 50 mg P.O once daily. Daily dose increase or decreased based on the BP Children ages 2 to 12:2.2 mg/kg or 60 mg/m2 daily in two divided doses. Usual dosage range is 37.5 to 100mg/day. Children ages 6 months to 2 years: 2.2 mg/kg or 60 mg/m2 daily in two divided doses. Usual dosage range is 12.5 to 37.5 mg/day. Children younger that age 6 months: Up to 3.3 mg/kg. P.O daily in two divided doses. Special Precaution: Impaired Hepatic and renal function Pregnancy Risk Category: B

Adverse Reaction: CNS: dizziness, vertigo , headache, paresthesia, weakness, restlessness. CV: orthosstatic hypotension, allergic myocarditis, vasculitis. GI: anorexia, nausea, pancreatitis, epigastric distress, vomiting, abdominal pain, diarrhea, constipation. GU: polyuria, frequent urination, renal failure, interstitial nephritis. Hematologic: aplastic anemia, agranulocytosis, leukopenia, thrombocytopenia, hemolytic anemia. Hepatic: Jaundicei Metabolic: asymptomatic hyperuricemia; hypokalemia; hyperglycemia and impaired glucose tolerance; fluid and electrolyte impbalances, including dilutional hyponatremia and hypochloremia; metabolic alkalosis; hyperkalemia; volume depletion and dehydration. MUSCULOSKELETAL: muscle cramps RESPIRATORY: respiratory distress, pneumonitis SKIN: dermatitis, photosensitivity reactions, rash, purpura, alopecia Other: hypersensitivity reactions, gout, anaphylactic reactions. Contraindications: Contraindication in patients with anuria and patients hypersensitive to other thiamizides or other sulfonamide derivatives. Form: Capsules: 12.5 mg

Oral solution: 50mg/5 ml Tablets: 25 mg, 50 mg. 100 mg Nursing Responsibility:  Use cautiously in children and in patients with sever renal disease, impaired hepatic function, or progressive hepatic disease.  To prevent nocturia, give drug in the morning.  Monitor fluid intake and output, weight, blood pressure, and electrolyte levels.  Watch for signs and symptoms of hypokalemia, such s muscle weakness and cramps. Drug may be used with potassium – sparing diuretic to prevent potassium loss.  Consult prescriber and dietitian about a high- potassium diet. Foods rich in potassium include citrus fruits, tomatoes, bananas, apricots, and dates.  Monitor creatinine and BUN levels regularly. Cumulative effects of drugs may occur with impaired renal function.  Monitor uric acid level, especially in patients with history of gout.  Monitor glucose levels, especially in diabetic patients.

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Monitor elderly patients, who are especially susceptible to excessive diuresis. Discontinue thiazides and thiazide like diuretic before parathyroid function tests. In patients with hypertension, therapeutic response may be delayed several weeks.