Glomerulin - General Information
A thiazide diuretic with actions and uses similar to those of hydrochlorothiazide. (From Martindale, The Extra Pharmacopoeia, 30th ed, p822)
Pharmacology of Glomerulin
Glomerulin is an oral thiazide used to treat hypertension and edema. High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. Like other thiazides, Glomerulin promotes water loss from the body (diuretics). Thiazides inhibit Na+/Cl- reabsorption from the distal convoluted tubules in the kidneys. Thiazides also cause loss of potassium and an increase in serum uric acid. Thiazides are often used to treat hypertension, but their hypotensive effects are not necessarily due to their diuretic activity. Thiazides have been shown to prevent hypertension-related morbidity and mortality although the mechanism is not fully understood. Thiazides cause vasodilation by activating calcium-activated potassium channels (large conductance) in vascular smooth muscles and inhibiting various carbonic anhydrases in vascular tissue.
Glomerulin for patients
(Effects may be decreased when used concurrently with thiazide diuretics; dosage adjustments may be necessary.)
(Thiazide diuretics may raise the level of blood uric acid; dosage adjustment of antigout medications may be necessary to control hyperuricemia and gout.)
Antihypertensive medications, other, especially diazoxide, or preanesthetic and anesthetic agents used in surgery or skeletal-muscle relaxants, nondepolarizing, used in surgery
(Effects may be potentiated when used concurrently with thiazide diuretics; dosage adjustments may be necessary.)
Amphotericin B or Corticosteroids or Corticotropin (ACTH)
(Concurrent use with thiazide diuretics may intensify electrolyte imbalance, particularly hypokalemia.)
(Concurrent use with thiazide diuretics may enhance the possibility of digitalis toxicity associated with hypokalemia.)
(May inhibit gastrointestinal absorption of the thiazide diuretics; administration 1 hour before or 4 hours after colestipol is recommended.)
(Thiazide diuretics may raise blood glucose levels; for adult-onset diabetics, dosage adjustment of hypoglycemic medications may be necessary during and after thiazide diuretic therapy; insulin requirements may be increased, decreased, or unchanged.)
(Concurrent use with thiazide diuretics is not recommended, as they may provoke lithium toxicity because of reduced renal clearance.)
(Effectiveness may be decreased when used concurrently with thiazide diuretics because of alkalinization of the urine.)
Nonsteroidal anti-inflammatory agents
(In some patients, the steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. Therefore, when hydroflumethiazide and nonsteroidal anti-inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of the diuretic is obtained.)
(Thiazides may decrease arterial responsiveness to norepinephrine. This diminution is not sufficient to preclude effectiveness of the pressor agent for therapeutic use.)
(Thiazide drugs may increase the responsiveness to tubocurarine.)
DIAGNOSTIC INTERFERENCE With expected physiologic effects:
Blood and urine glucose levels (usually only in patients with a predisposition for glucose intolerance) and
Serum bilirubin levels (by displacement from albumin binding) and
Serum calcium levels (thiazide diuretics should be discontinued before parathyroid-function tests are carried out) and
Serum uric acid levels (may be increased)
Serum magnesium, potassium, and sodium levels (may be decreased; serum magnesium levels may increase in uremic patients)
Serum protein-bound iodine (PBI) levels (may be decreased)
Thiazides should be discontinued before carrying out tests for parathyroid function.
Hypersensitivity to this or other sulfonamide-derived drugs.
Additional information about Glomerulin
Glomerulin Indication: Used as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Also used in the management of hypertension either as the sole therapeutic agent or to enhance the effect of other antihypertensive drugs in the more severe forms of hypertension.
Mechanism Of Action: As a diuretic, Glomerulin inhibits active chloride reabsorption at the early distal tubule via the Na-Cl cotransporter, resulting in an increase in the excretion of sodium, chloride, and water. Thiazides like Glomerulin also inhibit sodium ion transport across the renal tubular epithelium through binding to the thiazide sensitive sodium-chloride transporter. This results in an increase in potassium excretion via the sodium-potassium exchange mechanism. The antihypertensive mechanism of Glomerulin is less well understood although it may be mediated through its action on carbonic anhydrases in the smooth muscle or through its action on the large-conductance calcium-activated potassium (KCa) channel, also found in the smooth muscle.
Drug Interactions: Not Available
Food Interactions: Not Available
Generic Name: Hydroflumethiazide
Synonyms: Dihydroflumethazide; Hydroflumethazide; Hydroflumethizide; Hidroflumetiazid; Trifluoromethylhydrazide; Trifluoromethylhydrothiazide
Drug Category: Antihypertensive Agents; Diuretics, Thiazide
Drug Type: Small Molecule; Approved
Absorption: Hydroflumethiazide is incompletely but fairly rapidly absorbed from the gastrointestinal tract
Toxicity (Overdose): Overdoses lead to diuresis, lethargy progressing to coma, with minimal cardiorespiratory depression and with or without significant serum electrolyte changes or dehydration.
Protein Binding: 74%
Biotransformation: Essentially unchanged
Half Life: It appears to have a biphasic biological half-life with an estimated alpha-phase of about 2 hours and an estimated beta-phase of about 17 hours
Dosage Forms of Glomerulin: Tablet Oral
Chemical IUPAC Name: 1,1-dioxo-6-(trifluoromethyl)-3,4-dihydro-2H-benzo[e][1,2,4]thiadiazine-7-sulfonamide
Chemical Formula: C8H8F3N3O4S2
Hydroflumethiazide on Wikipedia: Not Available
Organisms Affected: Humans and other mammals