Diuréticos Tiazídicos

Descripción General

Descripción general de los LOS Neisseria agentes antihipertensivos

**Tabla: Medicamentos utilizados para tratar la hipertensión**
Lugar de acción	Clase	Subclases
Medicamentos renales	Medicamentos que afectan al AL Amyloidosis SRAA	IECA ARA Inhibidores directos de la renina
Medicamentos renales	Diuréticos	Diuréticos tiazídicos Diuréticos de asa ASA Anterior Cord Syndrome Diuréticos ahorradores de potasio
Medicamentos extrarrenales	Vasodilatadores directos	Bloqueadores de los LOS Neisseria canales de calcio Activadores de canales de potasio Nitrodilatadores Antagonistas de la endotelina
Medicamentos extrarrenales	Agentes que actúan a través del sistema nervioso simpático	Medicamentos que afectan la eferencia simpática del SNC (e.g., clonidina) Medicamentos que afectan los LOS Neisseria ganglios (e.g., hexametonio) Medicamentos que afectan las terminales nerviosas (e.g., guanetidina, reserpina) Medicamentos que afectan a los LOS Neisseria receptores α y β

Medicamentos de la clase de las tiazidas

Los LOS Neisseria medicamentos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum esta clase incluyen:

Hidroclorotiazida (medicamento prototípico de esta clase)
Clorotiazida
Clortalidona (agente de 1ra línea en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tratamiento de la hipertensión)
Indapamida
Metolazona

Química y Farmacodinamia

Estructura química

La estructura química de la hidroclorotiazida:

Fórmula molecular: C₇H₈ClN₃O₄S₂
Una benzotiadiazina que es 3,4-dihidro-2H-1,2,4-benzotiadiazina 1,1-dióxido con sustituciones de:
- Un grupo cloro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la posición 6
- Una sulfonamida en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la posición 7

Mecanismo de acción

Mecanismo de acción primario: ↓ reabsorción de NaCl a través de la inhibición del cotransportador Na⁺/Cl^– en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo contorneado distal:
- Con este canal bloqueado → ↓ reabsorción de Na⁺
- El agua siempre sigue al AL Amyloidosis Na⁺:
  - El agua permanece con el Na⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria túbulos ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum lugar de ser reabsorbida).
  - La diuresis resulta del efecto osmótico del Na⁺.
- Diuresis → ↓ volumen plasmático → ↓ presión arterial:
  - Inicialmente provoca un ↑ transitorio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el SRAA y el tono simpático para compensar la ↓ presión arterial y gasto cardíaco.
  - El ↑ transitorio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el SRAA explica el porqué existe un efecto sinérgico entre las tiazidas y los LOS Neisseria IECA/ARA.
- También hay un ↑ modesto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vasodilatación a través de un mecanismo poco claro.
El uso de las tiazidas da como resultado:
- ↑ Excreción de Na⁺, Cl^–, K⁺ y agua
- ↑ Reabsorción de Ca CA Condylomata acuminata are a clinical manifestation of genital HPV infection. Condylomata acuminata are described as raised, pearly, flesh-colored, papular, cauliflower-like lesions seen in the anogenital region that may cause itching, pain, or bleeding. Condylomata Acuminata (Genital Warts)²⁺:
  - ↑ Excreción de Na⁺ → ↓ niveles de Na⁺ celular →
  - ↑ Intercambio compensatorio de Ca CA Condylomata acuminata are a clinical manifestation of genital HPV infection. Condylomata acuminata are described as raised, pearly, flesh-colored, papular, cauliflower-like lesions seen in the anogenital region that may cause itching, pain, or bleeding. Condylomata Acuminata (Genital Warts)²⁺ por Na⁺ (a través del intercambiador basolateral Na⁺/ Ca CA Condylomata acuminata are a clinical manifestation of genital HPV infection. Condylomata acuminata are described as raised, pearly, flesh-colored, papular, cauliflower-like lesions seen in the anogenital region that may cause itching, pain, or bleeding. Condylomata Acuminata (Genital Warts)²⁺)
Desarrollo de hipopotasemia:
- ↓ Reabsorción de Na⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo contorneado distal →
- ↑ Na⁺ entregado a los LOS Neisseria túbulos colectores →
- Estimula la ↑ liberación de aldosterona
- La aldosterona estimula el intercambiador Na⁺/K⁺ para ↑ la reabsorción de Na⁺ y excretar K⁺ → hipopotasemia
Desarrollo de una alcalosis metabólica:
- ↑ Excreción de K⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria túbulos colectores →
- ↑ Intercambiador K⁺/H⁺ estimulado por la aldosterona →
- Se reabsorbe parte del K⁺ adicional en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo a cambio de H⁺ (que se excreta) → alcalosis metabólica a través de la pérdida de H⁺

Diuréticos tiazídicos que actúan sobre el cotransportador Na/Cl
Imagen por Lecturio. Licencia: CC BY-NC-SA 4.0

Farmacocinética

Tabla: Farmacocinética de los LOS Neisseria diuréticos tiazídicos
Medicamento	Absorción	Distribución	Metabolismo	Excreción
HCTZ HCTZ A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It is used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. Thiazide Diuretics	Buena absorción Efecto máximo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 4 horas Biodisponibilidad 65%–75%	V_d: 3,6–7,8 L/kg Unión a proteínas 40%–68%	No metabolizado	Orina Vida media: 6–15 horas
Clorotiazida	Mala absorción oral Efecto máximo: 30 minutos por vía intravenosa	Distribuido por todo el espacio extracelular	No metabolizado	Orina Vida media: 45–120 minutos
Clortalidona	Efecto máximo de 2–6 horas	V_d: 3–13 L/kg Unión a proteínas: 75%	Hepático	Orina Vida media: 40 horas
Indapamida	Absorción rápida y completa Efecto máximo: 2 horas	V_d: 25 L Unión a proteínas: aproximadamente 75%	Metabolismo hepático extenso	Orina: 75% Heces: 25%
Metolazona	Inicio de acción: 1 hora	V_d: 113 L Unión a proteínas: 95%	No metabolizado	Orina

HCTZ: hidroclorotiazida
V_d: volumen de distribución

Indicaciones

La mayoría de los LOS Neisseria diuréticos tiazídicos comparten indicaciones similares, que incluyen:

Hipertensión
Como terapia adyuvante para el edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las siguientes afecciones:
- Insuficiencia cardíaca
- Cirrosis hepática que resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ascitis
- Disfunción renal leve a moderada (ERC estadios 1–3):
  - Incluye ERC por síndrome nefrótico, glomerulonefritis, insuficiencia renal crónica
  - Nota: las tiazidas están relativamente contraindicadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con anuria Anuria Absence of urine formation. It is usually associated with complete bilateral ureteral (ureter) obstruction, complete lower urinary tract obstruction, or unilateral ureteral obstruction when a solitary kidney is present. Acute Kidney Injury/insuficiencia renal grave (ERC estadios 4 y 5).
- Uso de corticosteroides
- Terapia de estrógenos
Usos distintos al AL Amyloidosis de la ficha:
- Hipercalciuria
- Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus insípida

Perlas clínicas

Todos los LOS Neisseria pacientes deben ser monitorizados en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cuanto a presión arterial, creatinina, Na⁺ y K⁺.
Clortalidona e indapamida:
- Agentes de 1ra línea para monoterapia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tratamiento de la hipertensión
- 1,5–2 veces más potentes y con una vida media más larga que la hidroclorotiazida
- ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Heart attack Mi is ischemia and death of an area of myocardial tissue due to insufficient blood flow and oxygenation, usually from thrombus formation on a ruptured atherosclerotic plaque in the epicardial arteries. Clinical presentation is most commonly with chest pain, but women and patients with diabetes may have atypical symptoms. Myocardial Infarction Trial) mostró una reducción de los LOS Neisseria eventos cardiovasculares (tienen la mayor evidencia de todas las tiazidas).
- Puede tener ↑ efectos secundarios y riesgo de hipopotasemia
Hidroclorotiazida:
- Comúnmente utilizado como agente de 1ra línea para la hipertensión, aunque menos eficaz que la clortalidona o la indapamida
- Viene en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum píldoras combinadas con IECA, ARA y/o bloqueadores de los LOS Neisseria canales de calcio
- No tan eficaz con un aclaramiento de creatinina < 30 ml/min
Metolazona:
- Puede ser más eficaz que otras tiazidas con un aclaramiento de creatinina < 30 ml/min
- A menudo combinado con otros diuréticos

Efectos Secundarios y Contraindicaciones

Efectos secundarios

Tabla: Efectos secundarios de los LOS Neisseria diuréticos tiazídicos
Efectos secundarios de las tiazidas	Mecanismo	Tratamiento
Hipopotasemia	↑ Na⁺ urinario provoca ↑ intercambio de K⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria túbulos colectores → ↑ K⁺ excreción	↑ Ingesta dietética de K⁺ o suplementación
Hiponatremia e hipovolemia	↓ Reabsorción de Na⁺ que resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ↓ Na⁺ sérico; el agua sigue al AL Amyloidosis Na⁺, lo que puede provocar hipovolemia (lo más probable es que ocurra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las 1ras semanas de tratamiento)	↓ Dosis inicial Sin hipovolemia manifiesta: ↓ ingesta de agua libre Con hipovolemia manifiesta: reposición de Na⁺ con solución salina intravenosa.
Alcalosis metabólica	↑ Intercambio de iones K⁺ por H⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo colector	Suplementos de potasio y/o dosis más bajas/cambiar de agentes
Hipomagnesemia	No se ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia dilucidado por completo	Suplementación con Mg²⁺
Hiperuricemia	Las tiazidas ↑ reabsorción de urato	Evitar las tiazidas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con gota no tratada o con alto riesgo de gota.
Hipercalcemia	↑ Reabsorción de Ca CA Condylomata acuminata are a clinical manifestation of genital HPV infection. Condylomata acuminata are described as raised, pearly, flesh-colored, papular, cauliflower-like lesions seen in the anogenital region that may cause itching, pain, or bleeding. Condylomata Acuminata (Genital Warts)²⁺ inducida por tiazidas	Típicamente insignificante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ausencia de ERC o hiperparatiroidismo
Hiperglucemia	↓ K⁺ → hiperpolarización en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum células β pancreáticas → ↓ secreción de insulina Visto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum dosis más altas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus subyacente	Considerar agentes alternativos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus. ↓ Dosis de la tiazida Corregir la hipopotasemia. Tratar la diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus.
Dislipidemia	No se ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia dilucidado por completo El riesgo es ↓ con indapamida.	Monitorización de los LOS Neisseria lípidos Dieta y medicamentos hipolipemiantes
Fotosensibilidad	No se ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia dilucidado por completo	Usar protector solar y ropa protectora.
Hipersensibilidad	Alergia subyacente a las sulfonamidas	Evitar las tiazidas.

Contraindicaciones

Contraindicaciones de las tiazidas:
- Reacciones de hipersensibilidad
- Anuria Anuria Absence of urine formation. It is usually associated with complete bilateral ureteral (ureter) obstruction, complete lower urinary tract obstruction, or unilateral ureteral obstruction when a solitary kidney is present. Acute Kidney Injury y/o insuficiencia renal
- Hipotensión
- Hipopotasemia
- Alergia a las sulfamidas
- Gota
Precauciones con las tiazidas:
- Diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus
- Hipercalcemia
- Deterioro hepático
- Ciertos medicamentos:
  - Litio
  - Carbamazepina
  - Corticosteroides
  - AINE
- Embarazo y lactancia

Comparación de Medicamentos

Algunos de los LOS Neisseria otros diuréticos más comunes incluyen diuréticos de asa ASA Anterior Cord Syndrome (e.g., furosemida), diuréticos ahorradores de potasio (e.g., espironolactona), inhibidores de la anhidrasa carbónica (e.g., acetazolamida) y diuréticos osmóticos (e.g., manitol).

**Tabla: Comparación de diuréticos**
Medicamento	Mecanismo	Efecto fisiológico	Indicación
Diurético tiazídico: hidroclorotiazida	↓ Reabsorción de NaCl en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo contorneado distal a través de la inhibición del cotransportador Na⁺/Cl^–	↓ Presión arterial ↓ Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema	Hipertensión Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema
Diurético de asa ASA Anterior Cord Syndrome: furosemida	Inhibe el cotransportador luminal Na⁺/K⁺/Cl^– en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la rama ascendente gruesa del asa ASA Anterior Cord Syndrome de Henle	↓ Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema ↓ Presión arterial	Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema/ascitis ICC Hipertensión
Diurético ahorrador de potasio: espironolactona	↓ Reabsorción de Na a través de los LOS Neisseria canales de Na epitelial en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo colector Inhibe de los LOS Neisseria receptores de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo colector	↓ Presión arterial ↓ Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema No provoca ↑ excreción de K⁺ Efectos antiandrogénicos	ICC Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema/ascitis Hipertensión Hirsutismo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mujeres Hiperaldosteronismo primario
Inhibidor de la anhidrasa carbónica: Acetazolamida	Inhibe tanto la hidratación de CO₂ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células epiteliales del túbulo contorneado proximal como la deshidratación de H₂ CO ₃ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la luz del túbulo contorneado proximal; resulta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ↑ HCO₃^– y excreción de Na⁺	↑ Excreción urinaria de HCO₃^– → acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis metabólica ↓ Presión intraocular	Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con alcalosis metabólica Trastornos barométricos ↑ Presión intraocular Uso distinto al AL Amyloidosis de la ficha: hidrocefalia de presión normal
Diuréticos osmóticos: manitol	↑ Presión osmótica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el filtrado glomerular → ↑ líquido tubular e impide la reabsorción de agua	↓ Agua libre ↓ Volumen sanguíneo cerebral	Aumento de la presión intracraneal Aumento de la presión intraocular

Referencias

Akbari P, Khorasani-Zadeh A. (2025). StatPearls. Retrieved June 27, 2025, from https://www.ncbi.nlm.nih.gov/pubmed/30422513
Heymann, W. R. (2019). The expanding saga of hydrochlorothiazide and skin cancer. Journal of the American Academy of Dermatology, 80(2), 380–381. https://doi.org/10.1016/j.jaad.2018.12.006
Dhayat, N. A., Faller, N., Bonny, O., Mohebbi, N., Ritter, A., Pellegrini, L., et al. (2018). Efficacy of standard and low dose hydrochlorothiazide in the recurrence prevention of calcium nephrolithiasis (NOSTONE trial): Protocol for a randomized double-blind placebo-controlled trial. BMC Nephrology, 19(1), 349. https://doi.org/10.1186/s12882-018-1144-6
Roush, G. C., Abdelfattah, R., Song, S., Ernst, M. E., Sica, D. A., et al. (2018). Hydrochlorothiazide vs chlorthalidone, indapamide, and potassium-sparing/hydrochlorothiazide diuretics for reducing left ventricular hypertrophy: A systematic review and meta-analysis. Journal of Clinical Hypertension, 20(10), 1507–1515. https://doi.org/10.1111/jch.13386
Roush, G. C., Holford, T. R., Guddati, A. K., et al. (2012). Chlorthalidone compared with hydrochlorothiazide in reducing cardiovascular events: Systematic review and network meta-analyses. Hypertension, 59(6), 1110–1117. https://doi.org/10.1161/HYPERTENSIONAHA.112.191106
Sica, D. A., Carter, B., Cushman, W., Hamm, L., et al. (2011). Thiazide and loop diuretics. Journal of Clinical Hypertension (Greenwich), 13(9), 639–643. https://doi.org/10.1111/j.1751-7176.2011.00512.x
Mann, J. F. E., & Flack, J. M. (2025). Hypertension in adults: Initial drug therapy. In W. B. White (Ed.), UpToDate. Retrieved June 27, 2025, from https://www.uptodate.com/contents/hypertension-in-adults-initial-drug-therapy
Mann, J.F., Hilgers, K.F. (2024). Use of thiazide diuretics in patients with primary (essential) hypertension. In Forman, J.P. (Ed.), UpToDate. Retrieved June 27, 2021, from https://www.uptodate.com/contents/use-of-thiazide-diuretics-in-patients-with-primary-essential-hypertension
UpToDate. (2025). Hydrochlorothiazide: Drug information. UpToDate, Inc. Retrieved June 27, 2025, from https://www.uptodate.com/contents/hydrochlorothiazide-drug-information
Akbari, P. (2025). Thiazide diuretics. StatPearls. Retrieved June 27, 2021 from https://www.statpearls.com/articlelibrary/viewarticle/30055/

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