Background: If phototoxic:ity can be predetermined in vitro, the information will aid in prognosticating whether or not caimpounds have a photosensitizing pczrlial. OBJECTIVE: For the evaluation of the phototoxic potentials of reral drugs, we performed the Candida albicans test and the photohemolysis test. METHODS: The Candida altiicans test is based on growth inhibtion of Candida albicans after application of the drug and ultraviolet light A( UVA ) irradiatior and the photohemolysis test is based on hemolysis of red blood cells caused by irradiation ir the presence of photosensitizing compounds. In the Candida albicans test, clear zones around the drug patches were evaluated, which means positive results for the phototoxic potential of the drugs. In the photohemolysis test, the amounts of hemolysis were evaluated by measuring the relar absorbance at 540nm using a spectrophotometer. RESULTS: In the Candida albicans test, ibuprofen, naldix acid, chlorpromazine and thiodiphenylamine showed positive results, whereas others did not the photohemolysis test, griseofulvin, ibuprofen and nalicdixic acid showed increased amounts hemolysis at UVA and ultraviolet light B(UVB) irracliation, and chlorpromazine, thiodiphenylaiair, chlorothiazide and piroxicam showed increased amounts of hemolysis at UVA irradiation only. CONCLUSION: The results showed that both methods were goodness screening tests for demonstrating the phototoxicity of therapeutic drugs.
Candida albicans* ; Candida* ; Chlorothiazide ; Chlorpromazine ; Dermatitis, Phototoxic* ; Erythrocytes ; Griseofulvin ; Hemolysis ; Ibuprofen ; Mass Screening ; Piroxicam ; Ultraviolet Rays

Nephrogenic diabetes insipidus is a rare hereditary disorder characterized by insensitivity of the renal tubule to vasopressin. We report a case of nephrogenic diabetes insipidus associated with severe hydronephrosis in a 18 year old male, which was improved in urine volume, urine osmolarity and urine specific gravity with chlorothiazide therapy.
Adolescent ; Chlorothiazide ; Diabetes Insipidus, Nephrogenic* ; Humans ; Hydronephrosis* ; Male ; Osmolar Concentration ; Specific Gravity ; Vasopressins

Nephrogenic diabetes insipidus is a rare hereditary disorder characterized by insensitivity of the renal tubule to vasopressin. We report a case of nephrogenic diabetes insipidus associated with severe hydronephrosis in a 18 year old male, which was improved in urine volume, urine osmolarity and urine specific gravity with chlorothiazide therapy.
Adolescent ; Chlorothiazide ; Diabetes Insipidus, Nephrogenic* ; Humans ; Hydronephrosis* ; Male ; Osmolar Concentration ; Specific Gravity ; Vasopressins

A 13-year-old boy was diagnosed as having primary nephrogenic diabetes insipidus, and symptoms developed at 3 years of age. Subsequently he developed bilateral hydronephrosis and a neurogenic bladder. His pedigree could be explored back 5 generations and represented an inheritance as an X-linked recessive transmission factor. He was treated with indomethacin 2 mg/kg/day plus chlorothiazide 500 mg/day and this new treatment showed a markedly decreased urine output and increased urine osmolarity. (Nephrogenic diabetes insipidus, Hydronephrosis, Indomethacin)
Adolescent ; Bladder, Neurogenic/etiology ; Chlorothiazide/therapeutic use ; Diabetes Insipidus/complications ; Diabetes Insipidus/congenital* ; Diabetes Insipidus/drug therapy ; Diabetes Insipidus/genetics ; Drug Therapy, Combination ; Human ; Hydronephrosis/etiology* ; Indomethacin/therapeutic use* ; Male

Diuretics are among the most commonly used drugs. They primarily block active reabsorption of sodium at different sites in the nephron, thereby increasing urinary losses of NaCl and H2O. This ability to induce a negative fluid balance has made these drugs particularly useful in the treatment of a variety of conditions, edematous: congestive heart failure, nephrotic syndrome, liver cirrhosis, chronic renal failure, idiopathic edema, and nonedematous states: hypertension, hypercalcemia, nephrolithiasis, and syndrome of inappropriate antidiuretic hormone secretion. The diuretics are generally divided into three major classes, which are distinguished by the sites at which they impair the sodium reabsorption: loop diuretics at the thick ascending limb of the loop of Henle, thiazide-type diuretics at the distal tubule, and potassium-sparing diuretics at the cortical collecting tubule. The loop diuretics that are generally the most potent are furosemide, torasemide, and ethacrynic acid. The thiazide-type diuretics include chlorothiazide and metolazone. Spironolactone and amiloride are potassium-sparing diuretics. Diuretics should be started at an effective single dose and given intermittently with a subsequent increase in dose or frequency of administration. As a general rule, the rate of diuresis in an edematous patient should not exceed 1 to 2kg weight loss per day. In renal failure patients, loop diuretics at a higher than normal dose are required to get the desired diuretic effect because the diuretic excretion is often limited, in part due to the retention of organic anions. The patients with liver cirrhosis are responsive to spironolactone. After the administration of diuretics, even if a net diuresis is induced, the response is short-lived as a new steady state is rapidly established because the diuretic-induced sodium losses are counterbalanced by neuro-humorally mediated increases in tubular reabsorption at nondiuretic sensitive sites. This process is called compensatory antidiuresis or diuretic tolerance. Therefore sodium restriction is important when a patient is taking loop diuretics, and the concurrent use of a thiazide diuretic can inhibit downstream NaCl reabsorption, resulting in an exaggeration of diuresis. The most common side-effects are those encountered in virtually all the effective drugs: hypovolemia, hypokalemia and potassium depletion, hyperuricemia, and metabolic alkalosis. Other side-effects include hyperglycemia, hyperlipidemia, hyperuricemia, ototoxicity and sexual dysfunction. In addition, diuretics have the potential to increase the toxicity of several other agents. Nonsteroidal antiinflammatory drugs may antagonize the natriuretic effects of diuretics. The combination of potassium-sparing diuretics and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers may result in severe hyperkalemia.
Alkalosis ; Amiloride ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Anions ; Chlorothiazide ; Diuresis ; Diuretics* ; Edema ; Ethacrynic Acid ; Extremities ; Furosemide ; Heart Failure ; Humans ; Hypercalcemia ; Hyperglycemia ; Hyperkalemia ; Hyperlipidemias ; Hypertension ; Hyperuricemia ; Hypokalemia ; Hypovolemia ; Kidney Failure, Chronic ; Liver Cirrhosis ; Loop of Henle ; Metolazone ; Natriuretic Agents ; Nephrolithiasis ; Nephrons ; Nephrotic Syndrome ; Potassium ; Renal Insufficiency ; Sodium ; Sodium Potassium Chloride Symporter Inhibitors ; Spironolactone ; Water-Electrolyte Balance ; Weight Loss

Hydrochlorothiazide ; pharmacology ; Pharmacogenetics

Three groups of patients with newely diagnosed hypertension, or with hypertension not optimally controlled by previous treatment, completed a comparative study on the effects of Dihydrochlorothiazide, propranolol, and prazosin on plasma lipids after three months therapy. The drugs showed equipotent antihypertensive effects(P<0.01). Dihydrochlorothiazide administration was associated with a significant elevation of total cholesterol(42%, P<0.05), and triglyceride(8.1%, P<0.01). Changes of HDL-C(5.1%), LDL-C(3.3%), and cholesterol ratio(-4.8%) were not significant. Propranolol administration was associated with significant elevation of total cholesterol(3.8%, P<0.05), triglyceride(14.5%, P<0.005), and LDL-C(5.6%, P<0.005). Reduction of HDL-C(-7.8%, P<0.05) and cholesterol ratio(-14.7%, p<0.005) was also statistically significant. Prazosin administration was associated with significant decrease in total cholesterol(-6.6%, P<0.005), triglycride(-9.6%, P<0.005), and LDL-C(-11.7%, P<0.005), and significant elevation of HDL-C(10.6%,P<0.005) and cholesterol ratio(24.2%, P<0.005) was noted.
Cholesterol ; Humans ; Hydrochlorothiazide* ; Hypertension* ; Plasma ; Prazosin* ; Propranolol*

The effects of KCI continus tablet(K-Contin(R)) on the serum level of K and uric acid during hydrochlorothizide therapy(25mg/day) were evaluated in 30 patients with essential hypertensien. The results are as follows : 1) During hydrochlorothiazide therapy(25mg/day), 23% of all patients showed hypopotassemia(<3.5mEq/1) while no patient developed hypopotassemia after potassium supplement therapy(8 mEq/day). 2) During the period of K supplement, the level of serum uric acid showed less elevation. 3) The side reaction of KCI continus tablet were mild indigestion which developed in two patients and disappeared soon without any particular treatment. In conclusion, the KCI continus tablet is useful in the prevention of hypopotassemia during chronic diuretic therapy.
Dyspepsia ; Humans ; Hydrochlorothiazide ; Hypokalemia ; Potassium ; Uric Acid*

PURPOSE: We evaluated the effect of tamsulosin and hydrochlorothiazide (Dichlozid) on the expulsion of ureteral stones. MATERIALS AND METHODS: A total of 132 patients with a single ureteral calculi less than 10 mm in diameter were enrolled and divided into 3 groups: group 1 (n=40) received tamsulosin (0.2 mg/day), group 2 (n=35) received Dichlozid (25 mg/day) and tamsulosin (0.2 mg/day), and group 3 (n=57) was the control. Proximal and distal ureteral stones were evaluated separately. Efficacy was evaluated in terms of the rate and duration of expulsion according to stone size (<5 mm, > or =5 mm) for a maximum period of 4 weeks. RESULTS: The mean stone diameters were 4.9+/-1.7 mm (group 1), 4.8+/-1.6 mm (group 2), and 5.3+/-1.8 mm (group 3). The overall expulsion rates were 70%, 74.3%, and 52.6%, respectively, and showed statistical significance. The mean durations of expulsion were 14.7+/-1.6, 12.8+/-1.5, and 18.0+/-2.0 days, respectively, and group 2 showed a significant decrease in the duration. There were no significant differences in the expulsion rate of proximal and distal ureteral stones in any group. Distal ureteral stones in groups 1 and 2 showed a significant reduction in the mean expulsion time (<5 mm: 13.6+/-0.5, 11.8+/-0.7, and 16.7+/-0.8 days in groups 1, 2, and 3, respectively; > or =5 mm: 15.0+/-1.4, 13.0+/-0.6, and 17.8+/-0.4 days in groups 1, 2, and 3, respectively). The mean expulsion time for smaller proximal stones (<5 mm) in groups 1 and 2 was reduced significantly (17+/-0.6, 15.2+/-0.8, and 19.3+/-0.6 days in groups 1, 2, and 3, respectively). CONCLUSIONS: Medical therapy with tamsulosin is time-saving and effective for treating ureteral calculi. In addition, adjunctive treatment with Dichlozid may reduce the duration of expulsion.
Diuretics ; Humans ; Hydrochlorothiazide ; Sulfonamides ; Ureter ; Ureteral Calculi

BACKGROUND: To evaluate depressure effect and safety of delapril, a new ACE inhibitor, in Korea. METHOD: Thirty three patients, aged 37-69, with mild to moderate essential hypertension were first observed for 2 weeks with placebo followed by administration of 15mg of delapril twice daily for 2 weeks, then doubled dosage to 30mg b.i.d. and combined with 25mg of dihydrochlorothiazide if optimal BP were not obtained at the end of 4th week, continued the same dose until the end of 10 week's trial period. RESULT: BP dropped 15/9mmHg inaverage at the end of 10th week rewarding 70% of cumulative effectiveness. Most frequent side reaction was dry cough, occurred in 9% of patients followed by chest tightness, headache, constipation and transient elevation of GPT. CONCLUSION: Delapril 15-30mg twice daily as monotheraphy or combined with diuretics is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Constipation ; Cough ; Diuretics ; Headache ; Humans ; Hydrochlorothiazide ; Hypertension* ; Korea ; Reward ; Thorax