Hypokalemic Muscle Paralysis Associated With Administration of Chlorothiazide

Chlorothiazide is a new orally given diuretic whose potency equals that of the parenterally given mercurial diuretics.1While in vitro it appears to be a carbonic anhydrase inhibitor, the latter effect is not strikingly evident in vivo.2It acts directly on the renal tubules3in a manner similar to that of the mercurial diuretics.4The result is an increased excretion of sodium, potassium, and chloride in the urine, accompanied by diuresis. The side-effects do not appear to be troublesome.5Among those reported are (1) gastrointestinal disturbances, including nausea, vomiting, abdominal cramps, and epigastric distress; (2) hemorrhagic manifestations in which patients exhibited hematuria and petechiae without changes in the clotting mechanism; and (3) an exaggeration of epilepsy due to systemic alkalosis.5aWilkins5bhas reported sexual impotence as a complication of chlorothiazide therapy and Drerup and co-workers6treated a patient who developed jaundice with