Grapefruit-thiazide diuretic interaction

Dr. Kyriacou urges you to reconsider your answer. The presentation and labs fit rhabdomyolysis with acute kidney injury, suggested by severe myalgia, marked creatine kinase elevation, and a rise in creatinine. Hydrochlorothiazide is not significantly metabolized by CYP3A4, which metabolizes grapefruit juice, so grapefruit does not meaningfully raise its levels. If there was inhibition of thiazide metabolism, you would expect electrolyte disturbances, for example hypokalemia, that may produce cramps or weakness. Thiazides do not typically cause marked creatine kinase elevation and myoglobin‑mediated kidney injury. 

Please go back and re-consider. 

  • Presentation

Map: Mattias Garcia_ORU (1096)
Node: 20724
Score:

reset

OpenLabyrinth
OpenLabyrinth is an open source educational pathway system

Review your pathway

  • A higher magnification is needed to observe the cells
  • Still Bleeding
  • Opțiunea 1
  • Frog egg
  • Pertinent negatives
  • He makes noise.
  • ΕΞΙΤΗΡΙΟ ΜΕ ΑΝΤΙΕΠΙΛΗΤΙΚΗ ΚΑΙ ΑΠΟΙΔΗΜΑΤΙΚΗ ΑΓΩΓΗ
  • Medio bajo en glucosa para sistemas con energía limitada (DMEM-LG)
  • Προτείνεις να δώσεις χρήματα από τον κουμπαρά σου.
  • Τρόπος ζωής του ασθενούς
  • Results
  • Opțiunea 3
  • Ionuț va cere bani de la mama sa.
  • MAC
  • Ask Gastrointestinal Symptoms
  • Digoxin (digitalis, positive inotropic drug)
  • Opțiunea 2
  • Not satisfied
  • Treatment
  • Go to espresso house
  • Stop taking the medication immediately
  • Misses her follow up visit to the doctor
  • Keep on taking the anti-anxiety medications
  • Waiting the resource
  • If you use antacids, it's better to use calcium carbonate
  • new node
  • Ramipril (ACE inhibitor)
  • Επίσκεψη σε ρευματολόγο
  • Κάνει μόνο ψυχοθεραπεία
  • new node
  • how do you feel trying to lift your left arm, is it difficult?
  • Σταματάει προς το παρόν την ψυχοθεραπεία
  • Salbutamol (SABA)
  • Mechanism of action of GTN
  • Η ποιότητα ζωής του ασθενούς χειροτερεύει
  • Take suitable medication and adjust his behaviour
  • MAC
  • Opțiunea 1
  • The patient will be dissatisfied, and might not come to the next appointment and you will lose the follow up. You will also not have enough data about patient’s progress.
  • Pioglitazone
  • Go to a local cafe
  • Grapefruit-thiazide diuretic interaction

Reminder

empty_reminder_msg

FINISH

Time is up