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Any chloride deficit during thiazide therapy is generally mild and usually does not require any specific treatment except under extraordinary circumstancesas in liver disease or renal diseaseDilutional hyponatremia may occur in edematous patients in hot weatherappropriate therapy is water restrictionrather than administration of saltexcept in rare instances when the hyponatremia is life threateningIn actual salt depletionappropriate replacement is the therapy of choice.
Central Nervous Systemdrowsiness and fatigueinsomniaheadachedizzinessdry mouthdepressionanxietyvertigorestlessnessparesthesias.
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If hyperkalemia is suspectedwarning signs include paresthesiasmuscular weaknessfatigueflaccid paralysis of the extremitiesbradycardia and shockan electrocardiogramECGshould be obtainedHoweverit is important to monitor serum potassium levels because mild hyperkalemia may not be associated with ECG changes.
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