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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/27 17:37:54」(JST)

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Bendroflumethiazide (INN), formerly bendrofluazide (BAN), trade name Aprinox, is a thiazide diuretic used to treat hypertension.

Bendroflumethiazide is a thiazide diuretic which works by inhibiting sodium reabsorption at the beginning of the distal convoluted tubule (DCT). Water is lost as a result of more sodium reaching the collecting ducts. Bendroflumethiazide has a role in the treatment of mild heart failure although loop diuretics are better for reducing overload. The main use of bendroflumethiazide currently is in hypertension (part of the effect is due to vasodilation).

Adverse effects

Common adverse effects:^[3]

postural hypotension
hyponatraemia, hypokalaemia, hypercalcaemia
gout
impaired glucose tolerance
impotence
fatigue
pulmonary oedema
pneumonitis

Rare adverse effects:^[4]

thrombocytopenia
agranulocytosis
photosensitivity rash
pancreatitis
renal insufficiency

Alcohol

Bendroflumethiazide is known to have an adverse interaction with alcohol. It is advised that those using this diuretic should abstain from alcohol consumption during use, as it is possible to experience a sudden drop in blood pressure, especially if standing up.

Other considerations

Bendroflumethiazide should not be used by pregnant women, or women who have just given birth. Due to the nature of the medication, it is possible for it to pass into the breast milk and consequently to the child. It is also known that bendroflumethiazide suppresses the production of breast milk. Pregnant or lactating women with hypertension may need to discuss with their prescriber as to which alternative treatment may be more suitable. Bendroflumethiazide may also impair the user's motor skills, therefore it is important to be aware of its effects and to take caution when operating machinery of driving.^[5]

References

^ BNF 45 March 2003
^ Ed. Sean C. Sweetman (ed.). Martindale: The complete drug reference (33 ed.). Pharmaceutical Press.
^ Bendroflumethiazide Side Effects - Common euroClinix.co.uk
^ Bendroflumethiazide Side Effects Drugs.com
^ Bendroflumethiazide (Bendroflumethiazide 2.5mg tablets) NHS.uk^{[dead link]}

UpToDate Contents

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1. 原発性（本態性）高血圧患者におけるサイアザイド系利尿薬の使用 use of thiazide diuretics in patients with primary essential hypertension
2. 利尿剤の作用機序 mechanism of action of diuretics
3. 高血圧治療におけるサイアザイド系利尿剤とループ利尿剤の比較 thiazides versus loop diuretics in treatment of hypertension
4. 原発性（本態性）高血圧における薬物療法の選択：推奨 choice of drug therapy in primary essential hypertension recommendations
5. ループ利尿剤およびサイアザイド系利尿剤によって誘発された電解質の合併症の経過 time course of loop and thiazide diuretic induced electrolyte complications

English Journal

Perindopril arginine + amlodipine for the treatment of hypertension in the USA.

Elliott WJ1.
Expert opinion on pharmacotherapy.Expert Opin Pharmacother.2015 Sep 1:1-13. [Epub ahead of print]
INTRODUCTION: Controlling blood pressure is a global health priority; single-pill combinations of antihypertensive agents are often prescribed to improve adherence, persistence, and outcomes. Areas covered: A novel preparation of perindopril arginine and amlodipine besylate was approved by the US Fo
PMID 26325023

Describing sorption of pharmaceuticals to lake and river sediments, and sewage sludge from UNESCO Biosphere Reserve Kristianstads Vattenrike by chromatographic asymmetry factors and recovery measurements.

Svahn O1, Björklund E2.
Journal of chromatography. A.J Chromatogr A.2015 Aug 31. pii: S0021-9673(15)01258-3. doi: 10.1016/j.chroma.2015.08.061. [Epub ahead of print]
Over the past 30 years a vast number of studies have demonstrated the presence of pharmaceutical residues in the environment. But still knowledge is scarce regarding the interaction of these emerging pollutants with various matrices in nature. A chromatographic system with on-line detection was deve
PMID 26362805

Changes in urinary excretion of water and sodium transporters during amiloride and bendroflumethiazide treatment.

Jensen JM1, Mose FH1, Kulik AE1, Bech JN1, Fenton RA1, Pedersen EB1.
World journal of nephrology.World J Nephrol.2015 Jul 6;4(3):423-37. doi: 10.5527/wjn.v4.i3.423.
AIM: To quantify changes in urinary excretion of aquaporin2 water channels (u-AQP2), the sodium-potassium-chloride co-transporter (u-NKCC2) and the epithelial sodium channels (u-ENaC) during treatment with bendroflumethiazide (BFTZ), amiloride and placebo.METHODS: In a randomized, double-blinded, pl
PMID 26167467

Japanese Journal

Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering arm (ASCOT-BPLA) : a multicentre randomised controlled trial

DAHLOF B
Lancet 366, 895-906, 2005
NAID 30006142156

Direct determination of diuretic drugs in urine by capillary zone electrophoresis using fluorescence detection

GONZALEZ E.,BECERRA A.,LASERNA J.J.
Journal of chromatography. B, Biomedical applications 687(1), 145-150, 1996-12-06
NAID 10012418370

Related Pictures

★リンクテーブル★

リンク元	「100Cases 16」「ベンドロフルメチアジド」「bendrofluazide」

「100Cases 16」

Bendroflumethiazide
Systematic (IUPAC) name
	3-Benzyl-1,1-dioxo-6-(trifluoromethyl)-3,4-dihydro-2H-1,2,4- benzothiadiazine-7-sulfonamide
Clinical data
AHFS/Drugs.com	Consumer Drug Information
Pregnancy; category	Risk neonatal thrombocytopenia in 3rd trimester;
Legal status	UK: POM (Prescription only);
Routes of; administration	Oral
Pharmacokinetic data
Bioavailability	100%
Protein binding	96%
Metabolism	extensive
Biological half-life	3-4 hours
Identifiers
CAS Number	73-48-3
ATC code	C03AA01
PubChem	CID: 2315
IUPHAR/BPS	7122
DrugBank	DB00436
ChemSpider	2225
UNII	5Q52X6ICJI
KEGG	D00650
ChEBI	CHEBI:3013
ChEMBL	CHEMBL1684
Chemical data
Formula	C15H14F3N3O4S2
Molecular mass	421.415 g/mol
	SMILES FC(F)(F)c3c(cc1c(NC(NS1(=O)=O)Cc2ccccc2)c3)S(=O)(=O)N ;
	InChI InChI=1S/C15H14F3N3O4S2/c16-15(17,18)10-7-11-13(8-12(10)26(19,22)23)27(24,25)21-14(20-11)6-9-4-2-1-3-5-9/h1-5,7-8,14,20-21H,6H2,(H2,19,22,23) ; Key:HDWIHXWEUNVBIY-UHFFFAOYSA-N ;
(verify)

　　[★]

☆case16　膝の痛み

■glossary

indigestion 消化障害、消化不良

■症例

80歳　男性

主訴：左膝の痛みと腫脹

現病歴：左膝の痛みを2日前から認めた。膝は発熱・腫脹しており、動かすと疼痛を生じる。時々胸焼けと消化不良が見られる。6ヶ月前のhealth checkで、高血圧(172/102mmHg)と血中クレアチニンが高い(正常高値)こと以外は正常といわれた。その4週間数回血圧を測定したが、高値が継続したため、2.5mg bendrofluamethizide(UK)/ベンドロフルメチアジド bendroflumethiazide(US)で治療を開始した。最近の血圧は138/84 mmHgであった。

喫煙歴：なし。

飲酒歴：一週間に平均4unit。

既往歴：股関節に中程度(mild)の変形性関節症

家族歴：特記なし

服薬歴：アセトアミノフェン(股関節の疼痛に対して)

身体所見 examination

　血圧 142/86mmHg。体温37.5℃。脈拍88/分。grade 2 hypertensive retinopathy(高血圧症性網膜症)。心血管系、呼吸器系に検査場異常なし。手にDIPにヘバーデン結節なし。

　左膝が発熱し腫脹している。関節内に液、patellar tap陽性。90℃以上膝関節を屈曲させると痛みを生じる。右の膝関節は正常に見える。

検査　 investigation

　生化学：白血球増多、ESR 上昇、尿素高値、グルコース高値

　単純X線：関節間隙やや狭小。それ以外に異常は認めない。

■problem list

　#1 左膝の痛み

　#2 胸焼け

　#3 消化不良

　#4 高血圧

　#5 クレアチニン正常高値

　#6 股関節の変形性リウマチ

　#7 高血圧性網膜症

■考え方

　・関節痛の鑑別診断を考える。

　・VINDICATEで考えてみてもよいでしょう。

　・関節痛の頻度としては　外傷＞慢性疾患(OAなど)＞膠原病＞脊椎疾患＞悪性腫瘍

■関節痛の鑑別疾患

DIF 282

V Vascular 血友病 hemophilia, 壊血病 scurvy, 無菌性骨壊死 aseptic bone necrosis (Osgood-Schlatter diseaseとか)

I Inflammatory 淋疾 gonorrhea, ライム病 lyme disease, 黄色ブドウ球菌 Staphylococcus, 連鎖球菌 Streptococcus, 結核 tuberculosis, 梅毒 syphilis, 風疹 rubella, 単純ヘルペス herpes simplex, HIV human immunodeficiency virus, サイトメガロウイルス cytomegalovirus

N Neoplastic disorders 骨原性肉腫 osteogenic sarcoma, 巨細胞腫 giant cell tumors

D Degenerative disorders degenerative joint disease or 変形性関節症 osteoarthritis

I Intoxication 痛風 gout (uric acid), 偽痛風 pseudogout (calcium pyrophosphate), ループス症候群 lupus syndrome of hydralazine (Apresoline) and procainamide, gout syndrome of diuretics

C Congenital and acquired malformations bring to mind the joint deformities of tabes dorsalis and syringomyelia and congenital dislocation of the hip. Alkaptonuria is also considered here.