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Drug class Thiazide diuretic Mechanism of action Inhibits Na/Cl symporter in the distal convoluted tubule of the kidney Excretion of sodium and water blood volume blood pressure excretion of potassium, magnesium excretion of calcium (can help prevent kidney stones) Clinical uses Hypertension (first-line therapy) Edema (heart failure, nephrotic syndrome, cirrhosis) Prevention of calcium kidney stones Pharmacokinetics Well absorbed orally Renally excreted unchanged Not a prodrug Adverse effects Hypokalemia Hyponatremia Hyperuricemia gout Hyperglycemia (mild) Hypotension Hypercalcemia Contraindications / Caution Severe renal impairment Hypersensitivity to sulfonamides Hydrochlorothiazide = Active drug Chlorthalidone = Active drug Metolazone = Active drug Thiazide diuretics work directly

Kidney Int 38:912-918., 1990 14

Food is also a meaningful source of daily fluids fruits, vegetables, soups, and other water-rich foods can account for a notable share of total water intake