Thiazides false is
Ans. is 'd' i.e. Increases calcium excretion in urine Thiazides are moderate efficacy diureticsThey inhibit NaCl reabsorption from the luminal side of epithelial cells in the DCT by blocking the Na+Cl- transporterThiazides increase calcium reabsorption in the kidney tubules thus, decreasing calcium excretion. But thiazides rarely cause hypercalcemia as a result of this enhanced reabsorption, they can unmask hypercalcemia due to other causes.This effect on calcium makes them useful in the t/t of kidney stones caused by idiopathic hypercalciuria.Major indications of thiazide diuretics:-HypertensionHeart failureNephrolithiasis due to idiopathic hypercalciuriaNephrogenic diabetes insipidusAdverse effect of thiazide diuretics Hypokalemic metabolic alkalosisDue to the action of thiazides, more salts are delivered to the collecting tubule. Increased delivery leads to increased secretion of K+ and H+ by the duct causing hypokalemic metabolic alkalosis.Impaired carbohydrate tolerance (Hyperglycemia)Hyperglycemia may occur in patients who are overtly diabetic or who have even mildly abnormal glucose tolerance tests.The effect is due to both impaired pancreatic release of insulin and diminished utilization of glucose. HyperlipidemiaThiazides cause a 5-15% increase in total serum cholesterol and low density lipoproteins (LDL) HyperuricemiaThiazides cause increased reabsorption of uric acid.HyponatremiaIt is due to combination of hypovolemia induced elevation of ADH, reduction in the diluting capacity of the kidney and increased thirst.Allergic reactionsThe thiazides are sulfonamides and they share cross-relativity with other members of this group. Photosensitivity or generalized dermatitis occurs rarely. Serious allergic reactions are extremely rare but do include hemolytic anemia, thrombocytopenia and acute necrotizing pancreatitis.Other toxicitiesWeakness, fatigability and paresthesiasContraindications of thiazide diureticsHepatic cirrhosisBorderline renal failure
Used in CCF
Causes hyperglycemia
Increases uric acid concentration in serum
Increases calcium excretion in urine
Diuretic