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In patients with impaired liver function thiazide diuretics may cause hepatic encephalopathy. When it occurs, diuretics should be discontinued immediately.
Any diuretic drug may cause hyponatremia, in some cases accompanied by serious primobolan for women consequences. The level of sodium in the blood plasma is measured before treatment and then during treatment at regular intervals. Originally drop the sodium concentration in the blood plasma can be asymptomatic, so regular monitoring is important. In elderly patients and patients with cirrhosis of the liver monitoring should be more frequent. The greatest risk in the treatment of thiazide diuretics is hypokalemia. The risk of hypokalemia (less than 3.4 mmol / l) should be prevented in certain population groups at high risk, such as debilitated patients and / or taking multiple drugs, elderly patients, patients with liver cirrhosis, peripheral edema and ascites, ischemic heart disease and heart failure. In these patients, hypokalaemia increases the toxic effects of cardiac glycosides and the risk of arrhythmias.
It is also an increased risk include patients with prolonged QT interval on an electrocardiogram, for whatever reason – congenital or induced by drugs. Hypokalemia (as well as bradycardia) is a predisposing factor of severe arrhythmias, especially potentially dangerous type “pirouette”. All of these patients require more frequent monitoring of potassium concentration in the blood plasma. The first measurement of the concentration of potassium in the plasma must be held during the first week of treatment.
In identifying low potassium levels required its correction.
Control of blood glucose is important primobolan for women in diabetic patients, especially in the presence of hypokalemia.
In patients with hyperuricemia may increase the frequency of gout attacks. Thiazide and thiazide diuretics fully effective only under normal or slightly reduced (adult kreatinita clearance below 25 mg / l or 220 mmol / l) renal function. In elderly patients, plasma creatinine levels may vary depending on the age, weight and sex.
Secondary hypovolemia due to loss of water and sodium diuretic-induced early treatment causes a decrease in glomerular filtration. This may lead to increased levels of urea and creatinine in plasma. If renal function in a patient is not broken, then the transient functional renal failure usually takes place without consequences, but can worsen the already-existing renal impairment.
Athletes should take into account that the product contains an active substance which may cause a positive reaction in doping -control. Effects on ability primobolan for women to drive and use other mechanisms in some cases the individual reactions related to changes in blood pressure, especially at the beginning of treatment or when another antihypertensive agent is added. As a result, it may reduce the ability to drive a car and work with mechanisms that require attention. legal steroids bodybuilder arnold buy tramadol dnp bodybuilding