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I have a horrible feeling
I'm going to end up being the only user online.
1500 words left to go and then a heck of a lot of tidying up.
BUT, tomorrow = FANTOMAS MELVINS....!!!
16000 for me
you lightweight
i've never seen
"on_tha_run" and "I would" in the same sentence before...
3000 words to go
i think the time has come for me to stop making notes, summon some fucking gumption and do the damn essay.
2000 to go :(
'the text says what it cannot say' discuss
:( it's going to be a long night
good luck with that one. :\
very sorry for you
and on_tha_run isnt here to keep ypu up either, i though he would have been to be honest. iv got 10 pieces of work that need to be handed in by may 20th. oh the joy.
'Julia Kristeva and The Great War: A study of abjection and melancholia in Ernst Júnger's Storm of Steel.' EDGING towards finishing this one but then have 1000 to do on my kafka.
VERY LONG NIGHT! But misery loves company and all that
16, 000???? By when?
I also
can't stop listening to the prodigy experience. For some reason I find it really condusive to writing, along with lots of rat pack and orbital. jeesh.
i've got
various electronic/techno/hiphop stuff on. i'm not sure it's helping though. it's better than arcade fire and asobi seksu though, i had that on earlier and it just made me jump up and down a lot. things fell over. definitely not compatible with serious-faced essay writing.
ha that really made me laugh
electronic/techo ilk stuff is certainly the key.
Think I might venture a bit of Neurosis in a minute though...
I really want to go for a walk to clear my head but its raining. I receommend short walks by the way, definitely good.
well no
short walks = outside. outside = cold. and i think i'll lose the thread of what i'm thinking about. actually i'm not sure what i'm thinking about, but i bet i won't have a clue if i leave this room. hard concentration and blind determination is where it's at.
it's not due tomorrow or anything... got til thursday. but i want to get it well underway by tomorrow, and hopefully finished by tuesday.
mine's due Tuesday. Has to be finished by tomorrow so I can enjoy fantmelvins. Although at this rate i'm gonna be a zombie.
You'd be suprised how energy inducing a cold walk can be!!!
mine are due thursday and friday
I really really MUST do them before they get to a desperate situation on Wednesday and Thursday night. I probably won't though.
1 finished
now 600 odd words to bang out for no. 2.
sure you'll get there rapscalion. try and get the old essay writing addrenalin flowing.


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Top 5 luxury cars in 2014
Filed Under Chevrolet | Comments Off on Top 5 luxury cars in 2014
Are you looking forward to a luxury steam this year? Well, 2014 has witnessed the release of a number of plush cars till now from a host of esteemed auto makers. Be it Chevrolet or Mercedes or Jaguar or Cadillac- all have got something edgy for the luxury car aficionados this year.
Chevrolet Corvette Stingray
Debatably the most important new car for 2014, the Corvette Stingray from Chevy is one of the top-most luxury steams for this year. Available in convertible and coupe versions, Stingray Corvette is comprehensively re-designed with brand new chassis & mechanicals resting under a sensuously sleek bodyframe. The car is designed with a high-tech V8 6.2L engine that channels around 450 hp & 450 lb ft torque. Stingray speeds up from zero till 60 mph just within 3.8 seconds. The edgy "Drive Mode Selector" enables drivers to come up with 12 varied performance attributes as per 5 diverse driving situations. The car interior is gorgeous with its amazing roster of luxury amenities like rare seats mimicking hot-stone massage, climate control capacity, heated armrest etc.
Mercedes has followed a really outrageous approach with its S-Class elevating it as one of the unanimous choices regarding the plush-most vehicles of this year. The redesigned sedan flaunts a very elegant and bold styling and comes powered with a V8 twin-turbo engine producing 455 hp for S550 version. Another S-Class model, S63 4MATIC AMG is backed by a 5.5 l V8 engine that delivers 577 hp. The 2014 Merc S-Class has hit the headlines with its impressive roster of edgy chassis-control options such as low-pace autonomous drive mode, steering which automatically keeps this sedan centered in between the lane-markers on highway etc. There are many over-the-top-rack options in the car including rare seats emulating hot-stone massage, climate control capacity.
Wrapped in a dapper curvaceous styling, the F-Type from Jaguar is surely one of the most impressive luxury cars of 2014. It's a rear-drive 2-seater convertible which is armed with a vibrant V6 supercharged 3 l engine which produces either 380 or 340 hp, based on the very version chosen. The car also carries a 7-pace auto transmission which includes manual gear-select feature with the steering wheel-lifted paddle shifters. The F-Type is really lightweight but its aluminum structure promises a very rigid sturdy build.
The midsize ELR coupe from Cadillac is a plush 2-door electric car- flaunting a smart combo of style & environment consciousness. Taking cues from the other Cadillac makes, ELR has been designed with a very posh interior & assorted amenities. Powered by electric motor, the car can run up till 35 miles at a stretch on single charge. In case the charge falls short, there's a little gasoline engine to keep the car running.
BMW has taken up a major redesigning approach on its 3 series convertibles and coupes to present them as the 4 series makes this year. The 4 series models have arrived with 50 -50 near perfect weight-distribution to ensure impressive handling & various high-tech features- such as forward-collision warning facility, adaptive cruise-control, iDrive multimedia controlling system & dictation function.

subset: commoncrawl


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Tuesday, March 16, 2010
:: manuka honey ::
Manuka honey is on sale
(price excluding postage)
a spoon of Manuka honey per day, keeps a doctor away!
the best medicinal honey in the world!!!
Most of comprehensive studies on Manuka honey in various aspects have been done by Dr. Peter Molan and his stuff for over 2 decades from University of Waikato, New Zealand. You can read their research finding at the following link:
emeil me for further info..


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PRODUCT REVIEW: The Jojoba Company Hand CreamTuesday, March 01, 2016
Last year I reviewed The Jojoba Company's Hydrating Day Cream, and I STILL love this product. When Jojoba asked me to test out another one of their products, I was definitely on board. This time they sent me their lemon & coconut hand cream. I always talk about my issues with dry skin and I tend to focus on products for my face. However, last year I was diagnosed with Eczema for the first time, and ever since then, I've been on a mission to combat my dry skin issues all over my body. My hands also stay dry, and any new hand cream that can keep them moisturized is a win in my book.
The Jojoba Company is based in Australia and the co-founder Vicki Engall wanted to create a products that mimicked the natural oils found in the human body. She found this with the wax from jojoba beans. Grown on their own farm in Australia, the wax, or what we would call oil, is extracted from the beans that grown on the jojoba plant. Here's an excerpt from the website on the start of The Jojoba Company:
" I co-founded The Jojoba Company at about the same time I was starting my own family, so this skin care range was inspired by my commitment to a 'no nasties' home life: pure wholesome food, natural cleaning products and now my own skincare that is gentle, made from nature and safe. I have no time to read about all those chemicals and preservatives in the 'fine print'. I need to trust it is going to be pure—no excuses, no compromises."
~Vicki Engall, Co-Founder
~Vicki Engall, Co-Founder
As I get older and work readily in the world of chemicals with my day job, I care more and more about what goes in or on my body, and I've begun to favor natural products. This is not to say I'll never use a non-natural product again, because I'm sure my bathroom is stock full of them, but if I can find a natural alternative, why not?
So back to the review. Exactly how does one determine the effectiveness of beauty products? For me? I use 5 measurable categories: ethics, longevity, consistency, texture, and smell.
ETHICS - I love animals, and I don't really want to support a company that participates in animal testing, so I like when I read about beauty products that do not succumb to these practices. And as a Chemical Engineer, I prefer products that are as natural as possible, because those are the naturally occurring chemicals that I want to put on and in my body! The Jojoba Company is committed to animal friendly products, not testing their products on animals, and creating 100% natural products.
LONGEVITY - In my line of work, I don't have time to constantly re-apply lotion, or any beauty product for that matter. I want a product that can last throughout the day, or at least for the better part of a work day. I applied the hand cream at the beginning of my work day, and it lasted for the day! I do a lot with my hands at work, from typing, to touching objects and the field and just being outside in the environment. Grant it the last few days have been very nice, so I would love to see how this product measures up against a cold, arid day!
CONSISTENCY - I want a product to work the same every time I use it, or improve if it's one of those products that give better results the more you consistently use it. Nothing changed with the consistency of this product over the last few days. Again, I'm a big fan of the pump mechanism on this lotion bottle, which allows you to use the minimum amount of product needed.
|Before using the hand cream.
TEXTURE - Like food, I'm pretty picky with the feel of beauty products. I don't like overly greasy, slimy, or runny. A cream should feel like cream. The texture feels like cream and it comes out in strands versus a blob of mess on your hand. This isn't really that important, because when you go to rub it in, it becomes a blob as well! My hand as a little shiny after application , but the shine quickly wore off, and my hand felt very soft!
|Hand after the cream.
SMELL - Scents last a long time on the human body, and if I have to smell the product on me, it needs to be a favorable scent. Medicinial creams, like the one I had for my Excema, were definitely not pleasant to smell and then I was paranoid that people around me could smell it too. I also don't like OVERLY powerful scents, so it has to be just right. The lemon and coconut scent of this lotion was just right, not too strong and not too faint, however, I'm not really sure I could discern the lemon/coconut smell...maybe I just don't know what these two smell like! Ha! But the scent that came out was light and pleasant, so definitely tolerable!
Overall I really liked this hand cream and the engineer in me is in love with the bottle design! I also like how easy The Jojoba Company makes it to determine the products that are right for you. In just a few years they've already expanded their product offering. You can go to their website and shop by skin type/concern, or you can check out this booklet that they sent with my product that lists all of their products, their ingredients and what they help with. On the very last page you can make a checklist of the products you want to try! What are you waiting for? Head over to www.thejojobacompany.com.au today and try them out!
I received this product in exchange for an honest review.


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This past Christmas I bought a Living Social deal for one of their cooking classes. I thought it would be something new and fun my Dad and I could do together. With Valentine's Day coming up, this would be an AWESOME thing to do with your lover and I highly suggest it!
The great thing about living in Maryland is DC and Baltimore are both easily accessible. The Living Social DC headquarters is located right near the Verizon Center and driving to it and finding parking was actually easy!
We loved that you could buy beer or half bottles of cava/wine. The prices were decent and drinking while cooking makes everything better!
We started with a shrimp appetizer - easily my favorite meal we made.
The Living Social helpers bring you each round's (meal) ingredients pre-measured for you, which makes things really easy.
Our second course was mussels in a tomato based broth. Both my Dad and I usually don't touch these things, but we both ate the entire dish. It was really light and we held off on some of the spice - which was a good decision!
Our third course meal was our least favorite. I am usually a lover of calamari, but there wasn't enough breading and I definitely cooked these for too long :-(
Our fourth dish (and final course) was oven baked Moroccan white fish. It was delicious and even though the Living Social helpers placed it in the oven for the group, it came out awesome.
My Dad and I had such a great time, I definitely recommend these classes for anyone that wants to try something new, fun with friends/family/lovers!


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My life over the past few years has been quite the journey. Four years ago I was a 19 (almost 20) year old who was just about to start working at Best Buy for the Christmas season, and a few months later I moved to Boston to start at a tiny startup called gamerDNA. At gamerDNA I was the 8th employee and we worked from the CEO's kitchen table, grew to 20+, went through layoffs and lots of late nights, but created many great memories. Then for the past two years I've been living in San Francisco, working at various game companies, including Playfish for the past year, where I've been working with Facebook Game communities for The Sims and MONOPOLY. Life's been a fucking ride, man.
On Monday I announced that I was leaving Playfish and that I had accepted a Community Manager job at a small SF startup called RootMusic. This was the result of some soul searching, lots of hardwork, and it was a decision that frankly scared the shit out of me. At this point I'm pretty well connected in the video game industry, I've had the pleasure of working for some great companies with amazing people, and now I'm turning my back on all of that and starting fresh. Not only did I announce that I was leaving on Monday, but Tuesday was my last day at Playfish, and today was my first day at RootMusic. Intense, to say the least.
I'm extremely excited right now. It's currently 11pm, I got home just recently from my first day at work, and I'm honestly at a loss for words. I've got a huge amount of responsibility and a lot of people are looking to me to make some big decisions and be involved in many different projects. But this is what I've been looking for, I'll get to work at a music company that works with virtually every top Band/Musician in the industry, but also makes a product that a tiny high school garage band could use to great effect. The music industry is changing rapidly, and RootMusic will be there to lead the charge. To think that I've been fortunate enough to land a role at such a company just blows my mind, and I can't wait to spend many years with these great people and go onto this next chapter in my life journey.
This new job is going to be stressful, it's going to be really hard, and it's definitely going to be intense. But I'm really looking forward to a very rewarding experience, and I can't wait to make an impact on how Community Management is done in the music industry. This is very much like a dream job, a dream that I started to formulate recently as I prepared to meet Tom Delonge from Blink-182 and came up with a pitch to him/his manager for reasons they should hire me as their Social Media Manager. They didn't end up calling me back, but the important part was that it got my wheels turning in my head, and it got me to where I am today.
Today is a great day. I can't wait for tomorrow.


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What is best for making pies speaking of esp apple pie, a glass pie dish or a metal pie dish. I have a metal dish in which I make pie and I have found that they cook faster on the bottom then the top of the pie. Sometimes, they really burn a little bit on the bottom, although I place it on the upper rack in the oven..i was wondering is it the dish that makes a difference...or whatelse?
Glass is generally said to be best for pie pastry, because it doesn't reflect heat like metal does. I have made many many pies using both metal and glass plates, and never had the bottom crust burn. Usually if I have an issue it's that the bottom crust isn't cooked enough. The only way I can imagine getting a burned bottom crust is if the oven is still pre-heating when the pie goes in.
Oven thermometer would be a good idea. Glass is good. Nonstick will cook faster. Metal can be a little tempermental. I recommend going with a thick metal. But glass is the best for pies. Cook's Illustrated agrees. Just saying.
While I can only guess as to why you're having problems (not heating your oven thoroughly before baking? -- it takes a lot longer than most people think), I can tell you the best baking vessels for the purpose: Pyrex, ceramic and non-stick black steel. Each has its advantages. Pyrex allows you to see what's happening to the bottom crust. Emile Henry ceramic plates make the most elegant presentation with their fluted tops and the finish is virtually non-stick. Rose Levy Beranbaum's workhorse is Wilton's heavy steel 9-inch Excelle plate. They scratch though so I prefer the other two. Avoid shiny metal; it reflects heat. Pick up a Pyrex dish; they're inexpensive, versatile and a good learning tool.
One thing that I do preheat the oven, I have not made pie recently,,. I have made lot of pies to be honest...and by burnt I meant browns a little quicker than the top...and honestly, it is not a pie dish that i use it is actually a cake pan ..so i think so i should get a pie dish of glass...thanks a ton for suggestions...
I am attaching a pic , actually I made small pie as we are just two of us who were going to have it..the borders in the pic look extra extra brown...alright when I saw the bottom it wasn't this bad like the borders but it was certainly browner than the top crust..although it tasted very well..
Exposed edges can be covered with a strip of aluminum foil. It's a pretty common suggestion in pie recipes. Another variable is the crust recipe -- maybe this one isn't your best choice.
susang - I am aware about this tip to cover it with strip of foil..but still it browns ..but I have found my answer I think I should buy a glass dish...
This is a wonderful ceramic pie dish, also microwave and dishwasher safe:
It's not inexpensive but will last forever and has many other uses: for various desserts, as a casserole dish, serving dish, fruit bowl, etc. Made in Vermont.
I loved this pie dish...i liked the color..thanks Pegeen..and its multipurpose....also..thanks..
You're welcome! They also make a lovely pie dish with a fluted edge, but the straight-edge one above is probably more versatile - still have my grandmother's that she baked her soda bread in and also used for shepherd's pie. Their dishes will last longer than we will. ;-)
Pegeen's right about Bennington pottery lasting forever. I have a mug I was given as I went off to college, and that's a long, long time ago.


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Wusthof Classic Ikon Knife Block Set 9 Piece
Product code: WU9873
To add this product to your wishlist please login
9 Piece Classic Ikon Knife Set: Peeling Knife, Paring Knife, Sausage Knife, Carving Knife, Bread Knife, Santoku Knife, Cooks Knife, Sharpening Steel, Straight Meat Fork. The handy knife block provides protection for your blades as well as a visual compliment to your kitchen decor. Made of select beechwood, black.
Additional Information
- Brand: Wusthof
- Sub-Brand: Classic Ikon


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Spanish firm Fran Silvestre Arquitectos has recently designed a modern house located in a residential area in the city of Valencia in Spain called the Atrium House.
The inspiration behind the design is the concept of an atrium as the main entrance of a house. Silvestre, the architect behind the construction, has designed the house with light and space as the main themes. The residence is laid out, encompassing a central courtyard while the main living spaces surround the open space in the middle.
The home's main living quarters that wrap around the courtyard feature ceiling-to-floor glass panels that invite the exterior space into the interior space, providing a constant flow and connection to the inner space and nature. The building is L-shaped; while some rooms are able to view the outdoor swimming pool, other spaces allow natural light to come into the lower levels of the building.
L-Shaped European Residences
More Stats +/-
Minimalist Wooden Cabins
Reflective Camouflaged Houses
Structural Geometrical Villas
Staircase-Inspired Residences
Wave-Inspired Parks
Free 2019 Report & eBook
Get the top 100 trends happening right NOW -- plus a FREE copy of our award-winning book.
Our Research Methodology
This article is one of 350,000 experiments. We use crowd filtering, big data and AI to identify insights.
Silvestre's L-Shaped Atrium House Wraps Around a Central Courtyard
- By: TiffanyJan 24, 2014
References: highsnobiety
References: highsnobiety


text:
Design a Logo -- 2
Budget $10-30 USD
I need a logo for my online store [url removed, login to view]
Awarded to:
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70 freelancers are bidding on average $24 for this job
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text:
Till the end of 2016, our department has treated 1097 patients of stroke (including cerebral hemorrhage and cerebral thrombosis) sequela. Among these patients, the longest onset time is 19 years, and the shortest is one month (only few patients). The improvement rate of stroke (including cerebral hemorrhage and cerebral thrombosis) sequela is 88%. Many patients have a certain degree of improvement even when they were in hospital, and the improvement shows on:
1)lower muscular tension
2)increase of muscle force
3)better sensation of body
4)better blood circulation of distal limbs
5)better motor function and fexibilities
6) better pronunciation and facial expression
According to our clinical experience, factors such as the age of patient, length of disease time, severity of cerebral hemorrhage and cerebral thrombosis, controlling to complications as hypertension and diabetes, and condition of body function can influence the treatment effect. Normally, the shorter course of disease, the better therapeutic effect would be. More and more patients who suffered from cerebral hemorrhage or cerebral thrombosis received transplantation one or two months after onset, and the effect of treatment will show up several days after surgery.
At present, our department is trying to apply stem cell transplantation to treat cerebrovasucular disease sequela in acute stage and recovery stage. The animal experiments confirmed that using stem cell transplantation in acute stage and recovery stage can save a large amount of nerve cells around the cerebral injured area (ischemic penumbra), and restore their neurological function, hence reduce the disability rate and handicapped degree. Once the patient passed recovery stage and get into sequela stage, the best treating time is gone, and nerve cells around ischemic penumbra start dying, then some hard and dense glial scars which obstruct nerve regeneration will be formed around the injured area. It will be much more difficult to treat the disease then.
Stem cell transplantation leads to a new way to treat cerebrovasucular disease sequela which further improved patient's neurological function. The effect of treatment would be even better if patients practice proper and systematic functional rehabilitation excises after the transplantation. We will keep doing further research and study to improve our treatment effect and help as many patients as we can.


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Doberman Pinschers were created by Louis Dobermann, of Apolda, Germany, in the 1890s. Dobermann wanted a medium-sized dog who could be a companion dog and yet still serve as a guard dog. It is believed that Louis Dobermann used German Pinschers, Rottweilers, a black and tan Manchester Terrier, and a shorthaired shepherd to create his new breed. Some experts believe that there might also be some Greyhound mixed in. No matter what the ancestry, Louis Dobermann created a versatile working dog who has served ably in many capacities. In World War II, doberman dogs were integral to the success of so many operations that a war dog platoon was required to serve with every Marine Corps division.
Doberman Pinschers are dedicated, loyal companions.
The Doberman Pinscher today is a medium-sized dog who stands tall and carries himself proudly, making him look larger than he actually is. The Doberman Pinscher's head is wedgeshaped, the eyes almond-shaped and expressive, and the neck well-arched so that the head is carried proudly. For dog shows, the ears are cropped, although today many people retain the natural ears, which are folded. The Doberman's chest is broad, back is straight, and tail is docked. The coat is smooth, short, hard, and thick. The Doberman can be black, red, blue, or fawn; all four colors will have rust marking above the eyes, on the muzzle, throat, forechest, and all four legs, and below the tail.
Grooming the short coat is easy; brush it twice a week with a soft bristle brush or curry comb. During spring and fall, when shedding is at its worst, daily brushing will help keep hair in the house to a minimum. Doberman Pinschers need exercise, and a walk is certainly not enough. A run alongside a bicycle will be better, as will a vigorous game of catching a tennis ball or a good workout on the ground. Vigorous daily exercise is needed to keep a doberman fit and to prevent problem behaviors that will crop up when it is bored.
Doberman Pinschers today are much calmer than before, however, they are still excellent watchdogs and protectors. It's very important that puppies attend a puppy class where socialization is emphasized, especially to a variety of people. An overprotected and undersocialized Doberman Pinscher can be worried and fearful, neither a good trait for this proud breed. Training should begin young, too, not just to teach household rules and social manners – although both are important – but also to keep that intelligent, inquisitive mind busy! The Doberman Pinscher breed thrives on canine sports. Doberman Pinschers are dedicated, loyal companions, excellent with people of all ages, although puppies can be rowdy and need to be taught not to play roughly with children. They can be good with other pets and, when taught not to chase, with the family cat. They can be aggressive toward unknown dogs. Health concerns include cardiomyopathy, wobbler's syndrome, and von Willebrand's disease.
Doberman Pinschers are the target of a mistaken stereotype of ferocity and aggression. As a personal protection dog, the Doberman was originally bred for these traits: it had to be large and intimidating, fearless and willing to defend its owner, but sufficiently obedient and restrained to only do so on command. These traits served the dog well in its role as a personal defense dog, police dog or war dog, but were not ideally adapted to a companionship role.
In recent decades, the Doberman Pinscher's size, short coat, and intelligence made it a desirable house dog. Although these dogs are mistaken for their aggression, they are extremely loyal. They can easily learn to 'Respect and Protect' their owners. In response, they are excellent guard dogs that protect their loved ones. They are generally sociable towards humans and can be with other dogs, ranking among the more-likely breeds to show aggressive behaviour toward strangers and other dogs but not among the most likely. They are very unlikely to show aggressive behaviour towards their owners.
The Doberman Pinscher has ranked amongst the most intelligent of dog breeds in experimental studies and expert evaluations.
Many Doberman Pinschers are gentle, loyal, loving, and intelligent dogs, however, some lines are bred more true to the original personality standard. The personality of the Doberman Pinscher is peculiar to the breed. There is a great deal of scientific evidence that Doberman Pinschers have a number of stable psychological traits, such as personality factors and intelligence.
Read more information about the Doberman


text: Hi, I have installed a vodafone sim card in my new I pad, it is picking up a full signal but when I try to connect it gives a message saying I am not subscribed to a date service??? Is this a problem with the sim or do I need to do something on the I pad??? Dave


text:
Initial teacher training (ITT): accreditation
Find out how to become accredited to provide initial teacher training (ITT). Guidance for schools and training providers.
Eligibility criteria
You can only provide courses that lead to a recommendation for qualified teacher status (QTS) if you are accredited by the Department for Education (DfE).
DfE will only consider schools for accreditation that have been judged good or outstanding by Ofsted.
Accreditation process
The accreditation process is set out in the Arrangements for ITT accreditation submissions.
Your first step in the accreditation process is to attend a potential new provider briefing session.
Contact the DfE accreditation team if you would like to attend a briefing session. Places are strictly limited to 2 attendees per school.
When requesting places:
- provide details of the school seeking accreditation, including address and latest section 5 Ofsted grade
- specify if you're a teaching school and/or academy
We'll then ask you to submit a business case. We will assess it and offer feedback. Once approved, you need to prepare and submit a full accreditation bid. The business case and full bid should meet the criteria set out in the Arrangements for ITT accreditation submissions document.
ITT criteria
In order to be accredited, you must design training which meets the Secretary of State for Education's ITT criteria. You need to ensure that all programmes of ITT comply with the criteria. The ITT criteria also includes the withdrawal of accreditation criteria.
You must ensure that all trainees are assessed against the Teachers' Standards.
Ofsted will inspect you in accordance with the Ofsted initial teacher education framework.
To assist you in the early stages of your training, we have developed a post-accreditation support pack. This will be available upon accreditation.
Initial teacher training (ITT) accreditation
This email address is for potential new and accredited ITT providers. If you're a potential candidate, wishing to gain qualified teacher status (QTS), please visit https://getintoteaching.education.gov.uk/explore-my-options/teacher-training-routes/specialist-training-options.


text:
Class: Thiazide Diuretics
- Diuretics, Thiazide
VA Class: CV701
CAS Number: 58-94-6
Brands: Diuril
Medically reviewed on Feb 6, 2017
Thiazide diuretic and antihypertensive agent.
Uses for Chlorothiazide
Used alone or in combination with other antihypertensive agents for all stages of hypertension.b 110 500
Thiazide diuretics are recommended as one of several preferred agents for the initial management of hypertension; other options include ACE inhibitors, angiotensin II receptor antagonists, and calcium-channel blockers.501 502 503 504 While there may be individual differences with respect to specific outcomes, these antihypertensive drug classes all produce comparable effects on overall mortality and cardiovascular, cerebrovascular, and renal outcomes.500 501 502 504 Individualize choice of therapy; consider patient characteristics (e.g., age, ethnicity/race, comorbidities, cardiovascular risk) as well as drug-related factors (e.g., ease of administration, availability, adverse effects, cost).500 501 502 503 504 515
The optimum BP threshold for initiating antihypertensive drug therapy is controversial.501 504 505 506 507 508 515 523 530 Further study needed to determine optimum BP thresholds/goals; individualize treatment decisions.501 503 507 515 526 530
JNC 7 recommends initiation of drug therapy in all patients with uncomplicated hypertension and BP ≥140/90 mm Hg;500 JNC 8 panel recommends SBP threshold of 150 mm Hg for patients ≥60 years of age.501 Although many experts agree that SBP goal of <150 mm Hg may be appropriate for patients ≥80 years of age,502 504 505 530 application of this goal to those ≥60 years of age is controversial, especially for those at higher cardiovascular risk.501 502 505 506 508 511 515
In the past, initial antihypertensive drug therapy was recommended for patients with diabetes mellitus or chronic kidney disease who had BP ≥130/80 mm Hg;500 503 current hypertension management guidelines generally recommend a BP threshold of 140/90 mm Hg for these individuals (same as for the general population of patients without these conditions), although a goal of <130/80 mm Hg may still be considered.501 502 503 504 520 530 535 536 541
Black hypertensive patients generally tend to respond better to monotherapy with thiazide diuretics or calcium-channel blockers than to other antihypertensive drug classes (e.g., ACE inhibitors, angiotensin II receptor antagonists).109 500 501 504 However, diminished response to these other drug classes is largely eliminated when administered concomitantly with a thiazide diuretic or calcium-channel blocker.500 504
Thiazides may be preferred in hypertensive patients with osteoporosis. Secondary beneficial effect in hypertensive geriatric patients of reducing the risk of osteoporosis due to effect on calcium homeostasis and bone mineralization.
Edema (General)
Management of edema resulting from various causes; diagnose etiology before use.b 110 111
Edema caused by renal disease or by corticosteroids or estrogens may be relatively resistant to treatment.b
Ineffective in patients with Scr or BUN concentrations greater than twice normal.b
May be ineffective in patients with GFR <15–25 mL/minute; even when GFR is 25–50 mL/minute, more potent (e.g., loop) diuretics may be indicated.b
No substantial difference in clinical effects or toxicity of comparable thiazide or thiazide-like diuretics except metolazone may be more effective in edema with renal impairment.b
Edema in Heart Failure
Management of edema associated with heart failure.b c
Most experts state that all patients with symptomatic heart failure who have evidence for, or history of, fluid retention generally should receive diuretic therapy in conjunction with moderate sodium restriction, an agent to inhibit the renin-angiotensin-aldosterone (RAA) system (e.g., ACE inhibitor, angiotensin II receptor antagonist, angiotensin receptor-neprilysin inhibitor [ARNI]), a β-adrenergic blocking agent (β-blocker), and in selected patients, an aldosterone antagonist.524
Loop diuretics (e.g., bumetanide, ethacrynic acid, furosemide, torsemide) are diuretics of choice for most patients with heart failure.524
Do not use diuretics as monotherapy in heart failure even if symptoms (e.g., peripheral edema, pulmonary congestion) are well controlled; diuretics alone do not prevent progression of heart failure.
Diuretics produce rapid symptomatic benefits, relieving pulmonary and peripheral edema more rapidly (within hours or days) than cardiac glycosides, ACE inhibitors, or β-blockers (in weeks or months).
Diuretics should be continued in heart failure and comorbid conditions (e.g., hypertension) where ongoing therapy with the drugs are indicated.500
Edema Secondary to Nephrotic Syndrome
May be useful if the patient fails to respond to corticosteroid therapy.b
More likely to become refractory to thiazides than edema associated with congestive heart failure, and more potent diuretics may be required.b
Edema in Pregnancy
Generally responds well to thiazides except when caused by renal disease.b
Thiazides should not be used for routine therapy in pregnant women with mild edema who are otherwise healthy.b
Chlorothiazide Dosage and Administration
BP Monitoring and Treatment Goals
Carefully monitor BP during initial titration or subsequent upward adjustment in dosage.500 501
When available, use evidence-based dosing information (i.e., dosages shown in randomized controlled trials to reduce complications of hypertension) to determine target dosages; target dosages usually can be achieved within 2–4 weeks but may take up to several months.501
If adequate BP response not achieved with a single antihypertensive agent, add a second drug with demonstrated benefit; if goal BP still not achieved with optimal dosages of 2 antihypertensive agents, add a third drug.501 May maximize dosage of the first drug before adding a second drug, or add a second drug before maximizing dosage of the initial drug.501
Consider initiating antihypertensive therapy with a combination of drugs if patient's BP exceeds goal BP by >20/10 mm Hg.500 501 503 504
Goal is to achieve and maintain optimal control of BP; individualize specific target BP based on consideration of multiple factors, including patient age and comorbidities, and currently available evidence from clinical studies.500 501 (See Hypertension under Uses.)
Administer orally or IV.a 110 111 IV preparations not indicated for hypertension management.602
The injection must not be administered subcutaneously or IM, and extravasation of the alkaline solution must be avoided.a 111
Oral Administration
Administer chlorothiazide tablets and suspension orally.a 110
IV Administration
For solution and drug compatibility information, see Compatibility under Stability.
Administer chlorothiazide sodium by slow IV injection or by IV infusion; however, the IV route should be used only when patients are unable to take the drug orally or in emergency situations.a 111
Extravasation of the alkaline solution must be avoided.a 111
Reconstitute only with sterile water for injection.a
Addition of 18 mL of sterile water for injection to 500-mg vial provides a solution containing about 28 (27.8) mg/mL.a 111 No less than 18 mL of diluent should be used for initial reconstitution.a 111
The injection may be administered undiluted or may be further diluted with sodium chloride, dextrose, or other compatible infusion fluids before administration.a 111
Rate of Administration
Slowly by direct IV injection or by IV infusion.a 111
Dosage of chlorothiazide sodium is expressed in terms of chlorothiazide.a 111
IV and oral dosage are the same.a 111
Individualize according to requirements and response.a
If added to potent hypotensive agent regimen, initially reduce hypotensive dosage to avoid the possibility of severe hypotension.a
For the management of fluid retention associated with heart failure, experts state that diuretics should be administered at a dosage sufficient to achieve optimal volume status and relieve congestion without inducing excessively rapid reduction in intravascular volume, which could result in hypotension, renal dysfunction, or both.524
Pediatric Patients
Infants <6 months of age: May require up to 30 mg/kg daily given in 2 divided doses.110 601
Children 6 months to 12 years of age: Usually 10–20 mg/kg daily in 1 or 2 divided doses.110 601
Infants <6 months of age: May require up to 30 mg/kg daily given in 2 divided doses.110 601
Children 6 months to 12 years of age: Usually 10–20 mg/kg daily in 1 or 2 divided doses.110 601
Experience in infants and children is limited, and IV use in this age group generally is not recommended.a 111
Initially, 125–250 mg daily.101 102
Usual dosage: 125–500 mg daily in 1 or 2 doses.101 102 500
If adequate response is not achieved with monotherapy, add another antihypertensive agent.501
If intolerable adverse effects occur, consider dosage reduction; if adverse effects worsen or fail to resolve, may need to discontinue and switch to another antihypertensive drug class.501
Usually, 500 mg to 1 g daily in 1 or 2 doses.110 Occasionally, up to 2 g daily in 1 or 2 doses.a
After several days or when nonedematous weight is attained, dosage reduction to a lower maintenance level may be possible.a
For management of fluid retention associated with heart failure, some experts recommend initiating chlorothiazide at a low dosage (e.g., 250–500 mg once or twice daily) and increasing dosage until urine output increases and weight decreases, generally by 0.5–1 kg daily.524
With an intermittent schedule, excessive response and the resulting undesirable electrolyte imbalance are less likely to occur.a
Usually, 500 mg to 1 g daily in 1 or 2 doses.110 Occasionally, up to 2 g daily in 1 or 2 doses.a
After several days or when nonedematous weight is attained, dosage reduction to a lower maintenance level may be possible.a
With an intermittent schedule, excessive response and the resulting undesirable electrolyte imbalance are less likely to occur.a 111
For sequential nephron blockade in the management of fluid retention in heart failure, some experts recommend an initial dosage of 500 mg to 1 g once daily in combination with a loop diuretic.524
Prescribing Limits
Pediatric Patients
Infants <2 years of age: Maximum of 375 mg daily.a 110
Children ≥2 years of age: 1 g daily.a 110
Usual maximum is 500 mg daily.a 101 102 103 Higher dosages (up to 2 g daily in divided doses)110 e previously used but no longer recommended.101
Maximum recommended by manufacturer: 2 g daily in divided doses.a 110
Management of fluid retention in heart failure: 1 g maximum daily dosage recommended by ACCF/AHA.524
Maximum of 2 g daily in divided doses.a 111
Special Populations
Hepatic Impairment
No specific dosage recommendations for hepatic impairment; caution because of risk of precipitating hepatic coma.a 110 111
Renal Impairment
No specific dosage recommendations for renal impairment; caution because of risk of precipitating azotemia.a 110 111
Geriatric Patients
No specific geriatric dosage recommendations.a 110 111
Cautions for Chlorothiazide
Known hypersensitivity to hydrochlorothiazide, other thiazides, or any ingredient in the formulation.b
Although manufacturers state allergy to other sulfonamide derivatives is a contraindication,110 111 evidence to support cross-sensitivity is limited, and history of sensitivity to sulfonamide anti-infectives ("sulfa sensitivity") should not be considered an absolute contraindication.
Hypotensive Agents
May potentiate effects of other hypotensive agents.110 111 Although additive or potentiated antihypertensive effect usually is used to therapeutic advantage,500 hypotension could occur.110 111 b (See Interactions.)
Lupus Erythematosus
Possible exacerbation or activation of systemic lupus erythematosus.110 111
Generally, do not use with lithium salts.110 111 (See Interactions.)
Sensitivity Reactions
May occur with or without history of allergy or bronchial asthma.110 111
Sulfonamide cross-sensitivity unlikely. (See Contraindications under Cautions.)
General Precautions
Electrolyte Imbalance
Monitor for fluid or electrolyte imbalance (hyponatremia, hypochloremic alkalosis, hypokalemia).b 110 111
Observe for signs of electrolyte imbalance (e.g., dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, oliguria, muscle pains, cramps, muscular fatigue, hypotension, tachycardia, nausea, vomiting).110 111
Perform periodic serum electrolyte determinations (particularly of potassium, sodium, chloride, and bicarbonate); institute measures to maintain normal serum concentrations if necessary.b
Serum and urinary electrolyte measurements are especially important with diabetes mellitus, vomiting, diarrhea, parenteral fluid therapy, or expectations of excessive diuresis.b
Weekly (or more frequent) electrolyte measurement early in treatment; possible to extend interval between measurements to ≥3 months when electrolyte response has stabilized.b
May occur after brisk diuresis, when cirrhosis is present, or with prolonged therapy; inadequate oral electrolyte intake may contribute.110 111
May cause cardiac arrhythmias, exaggerate cardiac response to cardiac glycoside toxicity (increase ventricular irritability).110 111
Use potassium-sparing diuretics and/or potassium supplementation to avoid or treat hypokalemia.110 111
Generally mild, usually does not require specific treatment except in renal or hepatic impairment.110 111
Chloride replacement may be required for metabolic acidosis.109
Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate treatment usually is water restriction rather than salt administration except when hyponatremia is life-threatening.110 111
In actual salt depletion, appropriate replacement is treatment of choice.110 111
Hyperuricemia or, rarely, precipitation of gout may occur; generally avoid or use with caution in patients with history of gout or elevated uric acid concentrations.110 111 500 502
In diabetic patients, dosage adjustment of insulin or oral hypoglycemics may be required; hyperglycemia may occur and latent diabetes mellitus may become evident.110 111
Antihypertensive effect may be enhanced after sympathectomy.110 111
May increase magnesium urinary excretion, resulting in hypomagnesemia.110 111
May decrease calcium urinary excretion, cause slight intermittent serum calcium increase in absence of known calcium metabolism disorder; marked hypercalcemia may indicate hyperparathyroidism.110 111
Discontinue parathyroid tests.110 111
May increase cholesterol and triglyceride concentrations.110 111 109
Clinical importance of these changes is unknown.b Diet low in saturated fat and cholesterol usually compensates.b
Hypotensive Effects
Orthostatic hypotension occurs rarely.b
Specific Populations
Diuretics are considered second-line agents for control of chronic hypertension in pregnant women;142 500 if initiation of antihypertensive therapy is necessary in a pregnant woman, other antihypertensives (i.e., methyldopa, nifedipine, labetalol) are preferred.142 540
Edema associated with pregnancy generally responds well to thiazides except when caused by renal disease; however, routine use not recommended in pregnant women with mild edema who are otherwise healthy.b 110 111
Diuretics are not recommended for prevention or management of gestational hypertension or preeclampsia.141 539 540
Distributed into milk.h 110 111 141 Manufacturer states to discontinue nursing or the drug;110 111 however, considered to be compatible with breast-feeding.141
Pediatric Use
No controlled studies in children; use is supported by experience and published literature about hypertension treatment in children.110
Experience with IV chlorothiazide sodium in infants and children is limited, and IV use in this age group generally is not recommended.a 111
Geriatric Use
Elderly may be at increased risk of dilutional hyponatremia, especially underweight females with poor oral fluid and electrolyte intake or excessive low-sodium nutritional supplement intake.b (See Hyponatremia under Cautions.)
Hepatic Impairment
Use with caution in patients with hepatic impairment or progressive liver disease (particularly with associated potassium deficiency); electrolyte imbalance may precipitate hepatic coma.b 110 111
Discontinue immediately if signs of impending hepatic coma appear.b
Renal Impairment
Use with caution in severe renal impairment; thiazides decrease GFR and may precipitate azotemia.b 110 111 Effects may be cumulative in impaired renal function.b 110 111
Consider interruption or discontinuance if progressive renal impairment (rising nonprotein nitrogen, BUN, or Scr) occurs.110 111
Common Adverse Effects
Potassium depletion, hyperuricemia (usually asymptomatic; rarely leading to gout).b Hypochloremic alkalosis in patients at risk (e.g., hypokalemic patients).b Hyperglycemia and glycosuria in diabetics.b
Interactions for Chlorothiazide
Specific Drugs and Laboratory Tests
Drug or Test
Increased risk of postural hypotensionb
Thiazides may cause slightly more alkaline urinary pH; may decrease urinary excretion of some amines (e.g., amphetamine) with concurrent useb
Urine pH change is not great during thiazide use and, toxic blood concentrations of amines usually do not occurb
Monitor for signs of toxicity after initiation of thiazides in patients receiving amphetamineb
Amphotericin B
Additive/potentiated potassium lossb
Severe potassium depletion may occur when used concomitantlyb
Anticoagulants, oral
Postulated that may antagonize oral anticoagulant effectsb
Confirmatory evidence is lackingb
Antidiabetic agents (sulfonylureas)
Thiazide hyperglycemic effect may exacerbate diabetes mellitus, increase antidiabetic agent requirements, and/or cause temporary loss of diabetic control or secondary failure to antidiabetic agentb
Increased risk of postural hypotension with thiazidesb
Cholestyramine or colestipol
May bind thiazides, reduce their GI absorption, with cholestyramine reportedly producing greater binding in vitrob
Administer thiazides ≥2 hours before cholestyramine or colestipol when used concomitantlyb
Additive/potentiated potassium lossb
Severe potassium depletion may occur when used concomitantlyb
Additive/potentiated potassium lossb
Severe potassium depletion may occur when used concomitantlyb
May potentiate diazoxide hyperglycemic, hypotensive, and hyperuricemic effectsb
Use concomitantly with cautionb
Digitalis glycosides
Thiazide-induced electrolyte disturbances (principally hypokalemia, but also hypomagnesemia and hypercalcemia) may increase digitalis toxicity riskb
Perform periodic electrolyte determinations with concomitant use; correct hypokalemia if warrantedb
Hypotensive agents
Increased hypotensive effects of most other hypotensive agents b
Addition of thiazide to stabilized regimen with potent hypotensive agent (e.g., guanethidine sulfate, methyldopa, ganglionic blocking agent) may cause severe postural hypotensionb
Usually used to therapeutic advantageb
May exacerbate diabetes mellitus, increase insulin requirements, cause temporary loss of diabetic control, or secondary failure to insulinb
Thiazides (sometimes used with lithium to reduce lithium-induced polyuria), Reduced renal lithium clearance within several daysb
Can increase serum lithium concentrations and the risk of lithium intoxicationb
Occasionally, used to therapeutic advantage to reduce lithium-induced polyuria, but reduce lithium dosage by about 50% and monitor serum lithium carefullyb
Generally, avoid concomitant use because of increased lithium toxicity riskb
Urinary alkalinization may decrease the effectiveness of methenamine compounds which require a urinary pH of ≤5.5 for optimal activityb
Monitor urine pH during concurrent therapyb
Increased risk of NSAIA-induced renal failure secondary to prostaglandin inhibition and decreased renal blood flowb
NSAIAs may interfere with the natriuretic, diuretic, and antihypertensive response to diureticsb
Monitor closely for possible adverse effects and/or attenuation of diuretic-induced therapeutic effects during concomitant useb
Neuromuscular blocking agents (e.g., tubocurarine chloride or gallamine triethiodide [both no longer commercially available in US])
May cause prolonged neuromuscular blockadeb
Confirmatory evidence lackingb
Increased risk of postural hypotension with thiazidesb
Blocks thiazide-induced uric acid retentionb
Also blocks renal tubular secretion of thiazide, but effect on thiazide duration of action apparently not studiedb
Apparently enhances excretion of calcium, magnesium, and citrate during thiazide therapy, but urinary calcium concentrations remain below normalb
Sodium, potassium, ammonia, chloride, bicarbonate, phosphate, and titratable acid excretion apparently not affected by concomitant probenecid and thiazide therapyb
Used to therapeutic advantageb
Thiazides may cause slightly more alkaline urinary pH; may decrease urinary excretion of some amines (e.g., quinidine) with concurrent useb
Urine pH change is not great during thiazide use and toxic blood concentrations of amines usually do not occurb
Monitor for signs of toxicity after initiation of thiazideb
Test, Amylase (serum)
Values may be increased substantially in both asymptomatic patients and in patients developing acute pancreatitis who are receiving thiazidesb
Test, Corticosteroids (urinary) (Glenn-Nelson technique)
Decreased values by interfering in vitro with the absorbance in the modified Glenn-Nelson technique for urinary 17-hydroxycorticosteroids; may also decrease urinary cortisol excretionb
Importance of effect on urinary corticosteroids is unclearb
Test, Estrogens (spectrophotometric assay of total urinary estrogen; assay of estradiol)
Although hydrochlorothiazide causes falsely decreased values, similar interference does not occur with chlorothiazideb
Test, Histamine for pheochromocytoma
False-negative resultsb
Test, Parathyroid function tests
May elevate serum calcium in the absence of known disorders of calcium metabolismb
Discontinue thiazides prior to performing parathyroid function testsb
Test, Phenolsulfonphthalein (PSP)
Thiazides compete with PSP for secretion by the proximal renal tubulesb
Importance unknownb
Test, Phentolamine
False-negative resultsb
Test, Protein-bound iodine (PBI)
Values may be decreased, although usually not to subnormalb
Test, Triiodothyronine resin uptake
Decreased slightly, but 24-hour I 131 uptake is not affectedb
Test, Tyramine
False-negative resultsb
Vasopressors (e.g., norepinephrine)
Possible decreased arterial responsiveness to vasopressor amines b
Clinical importance not established;b decrease in pressor response not sufficient to preclude vasopressor use109
Chlorothiazide Pharmacokinetics
Incompletely and variably absorbed from the GI tract.a
Absorption from the GI tract appears to be site specific and saturable.a Several studies indicate that about 50 mg is absorbed following oral administration of a single 250-mg tablet, a single 500-mg tablet, or two 250-mg tablets to fasting healthy individuals.a
Diuretic effect (oral): within 2 hours; peak effect in 3–6 hours.b 109
Diuretic effect (IV): within 15 minutes; peak effect in 30 minutes.b
Hypotensive effect (oral): generally 3–4 days.b
Diuretic effect: 6–12 hours.b
Concomitant administration with food appears to increase the extent of absorption.a
Distributed in the extracellular space.a b
Readily crosses the placenta.a b 141
Distributed into breast milk.a h 141
Not metabolized.a
Elimination Route
Excreted unchanged in urine;a about 95% of an IV dose is eliminated in 5 hours and about 20 or 10% of a 250- or 500-mg oral dose, respectively, is eliminated in 48–72 hours.a
45–120 minutes.a
Tight, light-resistant containers at 20–25°C.601
Tight containers at 15–30°C; avoid freezing.600
Powder for Injection
For information on systemic interactions resulting from concomitant use, see Interactions.
Solution CompatibilityHID
Dextrose–Ringer's injection combinations
Dextrose–Ringer's injection, lactated, combinations
Dextrose–saline combinations
Dextrose 5% in sodium chloride 0.9%
Dextrose 2.5, 5, or 10% in water
Ionosol MB with dextrose 5%
Ionosol T with dextrose 5%
Ringer's injection
Ringer's injection, lactated
Sodium chloride 0.45 or 0.9%
Sodium lactate 1/6 M
Ionosol B with dextrose 5%
Normosol M in dextrose 5%
Normosol R in dextrose 5%
Drug CompatibilityHID
Lidocaine HCl
Nafcillin sodium
Ranitidine HCl
Amikacin sulfate
Chlorpromazine HCl
Hydralazine HCl
Polymyxin B sulfate
Prochlorperazine mesylate
Promethazine HCl
Exact mechanism of diuretic action is unclear; may act by altering metabolism of the tubular cells.b
Enhances excretion of sodium, chloride, and water by interfering with the transport of sodium ions across the renal tubular epithelium.b
Primary site of diuretic action appears to be the cortical diluting segment of the nephron.b
GFR decreases, but unclear whether secondary to a direct effect on renal vasculature or to the decrease in intravascular fluid volume or an increase in tubular pressure caused by the inhibition of sodium and water reabsorption.b The fall in GFR is not important in the mechanism of action.b
Enhances urinary excretion of potassium secondary to increased amount of sodium at distal tubular site of sodium-potassium exchange.b
Increases urinary bicarbonate excretion (although to a lesser extent than chloride excretion) but change in urinary pH is usually minimal; diuretic efficacy is not affected by the acid-base balance of the patient.b
Hypocalciuric effect is thought to result from a decrease in extracellular fluid (ECF) volume, although calcium reabsorption in the nephron may be increased; also, slight or intermittent elevations in serum calcium concentration.b
Rate of uric acid excretion is decreased, probably because of competitive inhibition of uric acid secretion or a decrease in ECF volume and a secondary increase in uric acid reabsorption.b
Hypotensive activity in hypertensive patients; also augments the action of other hypotensive agents.b Precise mechanism of hypotensive action has not been determined, but postulated that part of this effect is caused by direct arteriolar dilation.b
Advice to Patients
Advise patient of signs of electrolyte imbalance (e.g., dryness of the mouth, thirst, weakness, lethargy, drowsiness, restlessness, confusion, seizures, oliguria, or muscle pains or cramps, muscular fatigue, hypotension, tachycardia, GI disturbances such as nausea and vomiting).b
Advise patients of importance of compliance with scheduled determinations of serum electrolyte concentrations (particularly potassium, sodium, chloride, and bicarbonate).b
Advise hypertensive patients of importance of continuing lifestyle/behavioral modifications that include weight reduction (for those who are overweight or obese), dietary changes to include foods that are rich in potassium and calcium and moderately restricted in sodium (adoption of the Dietary Approaches to Stop Hypertension [DASH] eating plan), increased physical activity, smoking cessation, and moderation of alcohol intake.500
Advise that lifestyle/behavioral modifications reduce BP, enhance antihypertensive drug efficacy, and decrease cardiovascular risk and remain an indispensable part of the management of hypertension.500
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.
Importance of informing patients of other important precautionary information. (See Cautions.)
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Dosage Forms
Brand Names
250 mg/5 mL
250 mg*
Chlorothiazide Tablets
500 mg*
Chlorothiazide Tablets
* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name
Dosage Forms
Brand Names
For injection, for IV use only
500 mg (of chlorothiazide)*
Sodium Diuril
AHFS DI Essentials. © Copyright 2019, Selected Revisions February 6, 2017. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
Only references cited for selected revisions after 1984 are available electronically.
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102. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med. 1993; 153:154-83. http://www.ncbi.nlm.nih.gov/pubmed/8422206?dopt=AbstractPlus
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104. Izzo JL, Levy D, Black HR. Importance of systolic blood pressure in older Americans. Hypertension. 2000; 35:1021-4. http://www.ncbi.nlm.nih.gov/pubmed/10818056?dopt=AbstractPlus
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107. Associated Press (American Diabetes Association). Diabetics urged: drop blood pressure. Chicago, IL; 2000 Aug 29. Press Release from web site. http://www.diabetes.org/newsroom/
108. Appel LJ. The verdict from ALLHAT—thiazide diuretics are the preferred initial therapy for hypertension. JAMA. 2002; 288:3039-42. http://www.ncbi.nlm.nih.gov/pubmed/12479770?dopt=AbstractPlus
109. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002; 288:2981-97. http://www.ncbi.nlm.nih.gov/pubmed/12479763?dopt=AbstractPlus
110. Merck and Co., Inc. Diuril (chlorothiazide) tablets and oral suspension prescribing information. West Point, PA; 1998 Jun.
111. Merck and Co., Inc. Sodium Diuril (chlorothiazide sodium) IV powder for injection prescribing information. West Point, PA; 1999 Sep.
113. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003; 26(Suppl 1):S80-2.
141. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011:255-8.
142. ACOG task force on hypertension in pregnancy: hypertension in pregnancy. Washington, DC: American College of Obstetricians and Gynecologists; 2013.
217. The Guidelines Subcommittee of the WHO/ISH Mild Hypertension Liaison Committee. 1999 guidelines for the management of hypertension. J Hypertension. 1999; 17:392-403.
218. National Kidney Foundation Guideline. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis. 2002; 39(Suppl 2):S1-246.
500. National Heart, Lung, and Blood Institute National High Blood Pressure Education Program. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). Bethesda, MD: National Institutes of Health; 2004 Aug. (NIH publication No. 04-5230.)
501. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311:507-20. http://www.ncbi.nlm.nih.gov/pubmed/24352797?dopt=AbstractPlus
502. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31:1281-357. http://www.ncbi.nlm.nih.gov/pubmed/23817082?dopt=AbstractPlus
503. Go AS, Bauman MA, Coleman King SM et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014; 63:878-85. http://www.ncbi.nlm.nih.gov/pubmed/24243703?dopt=AbstractPlus
504. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich). 2014; 16:14-26. http://www.ncbi.nlm.nih.gov/pubmed/24341872?dopt=AbstractPlus
505. Wright JT, Fine LJ, Lackland DT et al. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014; 160:499-503. http://www.ncbi.nlm.nih.gov/pubmed/24424788?dopt=AbstractPlus
506. Mitka M. Groups spar over new hypertension guidelines. JAMA. 2014; 311:663-4. http://www.ncbi.nlm.nih.gov/pubmed/24549531?dopt=AbstractPlus
507. Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes?. JAMA. 2014; 311:474-6. http://www.ncbi.nlm.nih.gov/pubmed/24352710?dopt=AbstractPlus
508. Bauchner H, Fontanarosa PB, Golub RM. Updated guidelines for management of high blood pressure: recommendations, review, and responsibility. JAMA. 2014; 311:477-8. http://www.ncbi.nlm.nih.gov/pubmed/24352759?dopt=AbstractPlus
511. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008; 31:2115-27. http://www.ncbi.nlm.nih.gov/pubmed/19139601?dopt=AbstractPlus
515. Thomas G, Shishehbor M, Brill D et al. New hypertension guidelines: one size fits most?. Cleve Clin J Med. 2014; 81:178-88. http://www.ncbi.nlm.nih.gov/pubmed/24591473?dopt=AbstractPlus
520. American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014; 37 Suppl 1:S14-80.
523. Fihn SD, Gardin JM, Abrams J et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2012; 126:e354-471.
524. WRITING COMMITTEE MEMBERS, Yancy CW, Jessup M et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013; 128:e240-327.
526. Kernan WN, Ovbiagele B, Black HR et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2014; :. http://www.ncbi.nlm.nih.gov/pubmed/24788967?dopt=AbstractPlus
530. Myers MG, Tobe SW. A Canadian perspective on the Eighth Joint National Committee (JNC 8) hypertension guidelines. J Clin Hypertens (Greenwich). 2014; 16:246-8. http://www.ncbi.nlm.nih.gov/pubmed/24641124?dopt=AbstractPlus
535. Taler SJ, Agarwal R, Bakris GL et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for management of blood pressure in CKD. Am J Kidney Dis. 2013; 62:201-13. http://www.ncbi.nlm.nih.gov/pubmed/23684145?dopt=AbstractPlus http://www.pubmedcentral.nih.gov/picrender.fcgi?tool=pmcentrez&artid=3929429&blobtype=pdf
536. Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl. 2012: 2: 337-414.
539. Churchill D, Beevers GD, Meher S et al. Diuretics for preventing pre-eclampsia. Cochrane Database Syst Rev. 2007; :CD004451.
540. Magee LA, Pels A, Helewa M et al., for the Canadian Hypertensive Disorders of Pregnancy (HDP) Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertens. 2014; 4:105-45. http://www.ncbi.nlm.nih.gov/pubmed/26104418?dopt=AbstractPlus
541. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012; 33:1635-701. http://www.ncbi.nlm.nih.gov/pubmed/22555213?dopt=AbstractPlus
600. Salix Pharmaceuticals. Diuril (chlorothiazide) oral suspension prescribing information. Raleigh, NC; 2011 Oct.
601. Mylan Pharmaceuticals. Chlorothiazide tablet prescribing information. Morgantown, WV; 2006 Mar.
602. Oak Pharmaceuticals. Intravenous Sodium Diuril (chlorothiazide sodium) prescribing information. Whitehouse Station, NJ; 2012 May.
a. AHFS drug information 2017. McEvoy GK, ed. Chlorothiazide. Bethesda, MD: American Society of Health-System Pharmacists; 2017: .
b. AHFS drug information 2017. McEvoy GK, ed. Thiazides general statement. Bethesda, MD: American Society of Health-System Pharmacists; 2017: .
c. AHFS drug information 2007. McEvoy GK, ed. Cardiac glycosides general statement. Bethesda, MD: American Society of Health-System Pharmacists; 2007: 1584-91.
d. AHFS drug information 2007. McEvoy GK, ed. Captopril. Bethesda, MD: American Society of Health-System Pharmacists; 2007: 1835-45.
e. American Hospital Formulary Service drug information 84. McEvoy GK, ed. Hydrochlorothiazide. Bethesda, MD: American Society of Health-System Pharmacists; 1984: 984-5.
h. American Academy of Pediatrics. The Transfer of Drugs and Other Chemical into Human Milk. Pediatrics. 2001; 108:776-789. http://www.ncbi.nlm.nih.gov/pubmed/11533352?dopt=AbstractPlus
HID. Trissel LA. Handbook on injectable drugs. 17th ed; Bethesda, MD: American Society of Health-System Pharmacists; 2013:258-9.
More about chlorothiazide
- Chlorothiazide Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
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- En Español
- 1 Review
- Drug class: thiazide diuretics
Consumer resources
Professional resources
- Chlorothiazide Sodium (AHFS Monograph)
- Chlorothiazide (FDA)
- Chlorothiazide Injection (FDA)
- Chlorothiazide (Wolters Kluwer)
Other brands: Diuril


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Nordic Game Jam this weekend – yay! :)
This weekend a buddy of mine and I are driving to Copenhagen to participate in Nordic Game Jam.
The sign-up closed at 260 participants, that will be my biggest jam yet :).
For those of you who haven't participated in a Game Jam yet - DO IT!
Here's a short excerpt from the NGJ webpage about why you should try it. It sums it up pretty well:
But why participate in a game jam? And why go through 48 hours of: very little sleep, hard work, great ideas, crunching, problem solving & technical issues? Because a game jam encourages innovation and experimentation. It is one of the vehicles behind the new generation of game developers that can experiment with platforms and game ideas in an intense and yet still informal atmosphere. This is the space where the new generation of talents can be found.
If you urge to create a game, collaborate and meet other game developers - then Nordic Game Jam is the perfect place for you. As a participant at the Nordic Game Jam you will be part of a global event of creativity and fun.
The Nordic Game Jam 2010 will follow the same format like previous years, as an event where students, hobbyists and professional game developers, meet up for a weekend to develop and experiment with new and innovative game ideas.
My version of the 10 second pitch sounds like this:
"It's an excellent chance to pick up new skills and friends while doing what you like best - code XNA ;-)."
Nordic Game Jam will be opened by Carina Christensen, Danish Minister of Culture - which I think is a proper recognition for the role games play in the development of a common culture.
But more importantly: Peter Molyneux, yes THE Peter "Populous-DungeonKeeper-Black and White" Molyneux will be doing the Keynote speech.
To me Peter is synonymous with Artificial Intelligence. Like no other he made me believe that the characters you saw on the screen had a life of their own, even after turning off the PC
Can hardly wait!
Tags: Game Jam


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Tuesday, March 4, 2014
Thoughts on the 86th Academy Awards
1. The acting-nominees clips (long my favorite thing about Oscar night) were, as usual, hit and miss. Of course, they showed Jennifer Lawrence's American Hustle bathroom showdown with Amy Adams for Lawrence's category (Best Supporting Actress), but I'm not sure why they didn't go with Adams' comeback for Best Actress instead of her dismissal of Christian Bale on the tarmac, which was good mostly for her punchline ("You're nothing until you're everything")....
Matthew McConaughey had far better scenes than his post-AIDS diagnosis hospital confrontation with Jennifer Garner, but it was nice to have some acknowledgement that she was in the film, too. (Shame on Jared Leto for not mentioning her in what was an otherwise flawless acceptance speech.)...
Bruce Dern's quiet Nebraska turn was more effective for the cumulative effect of all his scenes rather than for individual ones, so his clip never stood a chance against his showy fellow nominees....
Taken out of context of Dallas Buyers Club, Jared Leto's clip moved me more than the performance did overall. I still contend that he was playing Rayon more as an effeminate and very theatrical gay man than as a convincing transgender woman....
Sally Hawkins' Best Supporting Actress Blue Jasmine clip provided more ammunition for Cate Blanchett's eventual Best Actress win, and Meryl Streep's just highlighted everything I hated about her performance in August: Osage County as well as her previous two Oscar-nominated performances. Not even the Oscar queen can make hammy overacting work.
3. Three dreams on my Oscar wish lift came true: No "In Memoriam" popularity-contest applause, a Cate Blanchett triumph, and Best Supporting Actress Oscar winner Lupita Nyong'o remembering to acknowledge 12 Years a Slave costar Sarah Paulson -- who was like the Jennifer Garner of that movie -- in her acceptance speech. (Fun fact: Paulson also appeared in another 2013 McConaughey film, Mud.) I don't believe I saw Paulson there, though. Did she go up on the stage for 12 Years' Best Picture win? Although I wasn't rooting for 12 Years, I'm secretly glad it won because now producer Brad Pitt can call himself "Oscar winner Brad Pitt," and a few years from now the Academy won't have to feel obligated to give him one of those he's-due awards. Leonardo DiCaprio and Johnny Depp deserve it more.
4. I loved that Christoph Waltz presented Nyong'o's Best Supporting Actress Oscar. Not just because he says her name so appealingly but also because Nyong'o was to 12 Years a Slave what Kerry Washington was to Django Unchained, the 2012 film for which Waltz won his second Best Supporting Actor Oscar last year. I don't think any woman at the Oscars looked better than Nyong'o and Washington, who was a presenter. Although Washington has Scandal and a baby on the way, I still feel bad that she's always an Oscar presenter (well, for the second time), never a nominee.
5. My favorite acceptance-speech line of the night: "The world is round, people." -- Cate Blanchett. She had more of an edge than I usually associate with her. I'd like to be in on that inside " hashtag suck it" joke between her and Julia Roberts, who seemed to get it and take it in stride.
6. As I told a friend on Facebook, I could spend all day looking at Spike Jonze and/or watching his movies. He's that adorable. I had my issues with Her, but Best Original Screenplay couldn't have gone to a more deserving guy. I normally hate it when directors try to act, but I even liked what he did in The Wolf of Wall Street. If only Jonze swung the way his character did.
7. I've never really understood the appeal of the random montages. Did we really need two tributes to heroes (animated and real-life ones)? Why not cut one, or both, or condense them into one, and then expand "In Memorian" to include recently departed TV icons Ralph Waite and Jean Stapeleton, both of whom also appeared in films (The Bodyguard and You've Got Mail, to name two, respectively). Oh, well. There's always the Emmys, and for Waite, who most recently appeared on Days of Our Lives as Father Matt, the Daytime Emmys, too.
8. I'm still not sure what to make of some of the presenters. Goldie Hawn seemed random, but she's a legend. Ditto, Kim Novak. Kate Hudson, who has not made a significant contribution to film in years, is not....
Will Smith is one of the biggest stars in Hollywood, but he still doesn't feel Best Picture presenter-caliber. Smith and Poitier would have made more sense, but the Academy probably didn't want to be too obvious. By pairing Poitier with Angelina Jolie to present Best Director, a win for Steve McQueen (12 Years a Slave) over Alfonso Cuaron (Gravity) seemed almost possible, if not quite probable. Since Bette Midler and Hawn were already there, why didn't they invite Diane Keaton and make the Best Picture announcement a First Wives Club reunion?...
I appreciated the inclusion of previous nominees like Gabourey Sidibe and Anna Kendrick, but Chris Evans, who has never appeared in anything resembling an Oscar-caliber film, is so MTV Movie Awards, and Jessica Biel's Best Original Score/Best Original Song co-presenting spot should have gone to her husband Justin Timberlake, who's both an actor and a singer, sort of like Biel's co-presenter, Jamie Foxx.
10. For the first time ever, Sidney Poitier, 87, looks frail. He's like the still-living Nelson Mandela of Hollywood, the epitome of legendary screen greatness. Angela Lansbury, 88, who appeared in the pre-taped lifetime-achievement presentation section, is still looking at least a decade and a half younger than she is. Meanwhile, Brad Pitt, who turned 50 in November, appears to have discovered Benjamin Button's -- or Jared Leto's -- secret to aging backwards. Ditto Jim Carrey. He and Brad kind of have me looking foward to 50, which since all of the major categories were, as usual, utterly predictable, was perhaps the biggest surprise of Oscar night 2014.
Posted by Jeremy Helligar at 1:24 AM
Labels: 12 Years a Slave, Academy Awards, Amy Adams, Brad Pitt, Cate Blanchett, Ellen Degeneres, Jared Leto, Jennifer Lawrence, Jessica Biel, Leonardo DiCaprio, Matthew McConaughey, Meryl Streep, Oscars, Sidney Poitier
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Toronto Festival and Events Calendar
Summer in Toronto. Definitely, one of the best times of the year to go out and explore all that our city has to offer. With so many places to visit and activities available, one can really experience first hand, it's unique urban life.
Many may seek to enjoy its multicultural diversity, in all its forms and expressions, through several of the festivals and culinary offerings that take place throughout the year. While others may simply choose to go outdoors and enjoy life under the sun or close to the water.
But no matter what your preference is, how can you manage to have all of these activities come to your attention? Do you find your bearings through word of mouth, rely on direct invites or do you come to know about them by interacting socially online?
The truth is that no matter how the information ultimately reaches you, it tends to be quite difficult to keep track of all of these potential options.
Fortunately, thats when a link to the Toronto Festival and Events Calendar becomes useful.
By accessing:
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you can view a complete and updated list of all the activities taking place in the city during the summer and all throughout the year.
You can find options like "Taste of the Danforth", to "TIFF in the Park", all the way to a "Toronto on the Water" exhibit, amongst many others.
I hope you find this link useful and the information in it to be of interest.
With so much to do, the challenge may now be to find the time to experience it all!
See you around at the upcoming events.
Should you have any questions about this post, our city or need any assistance in the Real Estate market, feel free to email me or call me. I'm an active part of our InterNations community and will be glad to be of help.
Best regards,
Jose Castillo
Real Estate Sales Representative
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There's no better way to get in the holiday spirit than this story about an unbelievably kind gesture by Indianapolis Colts offensive lineman Mike McGlynn.
Last week McGlynn's wife, Megan, was watching the local news when she saw a piece about a mother of three whose minivan full of Christmas presents had been robbed on "Black Friday." The mother, 31-year-old Lori Diehl, is a teacher on maternity leave. Diehl's husband, Matthew, is also a teacher. The Diehls are in the midst of an unthinkable year, struggling emotionally and economically as Lori took off for maternity leave and Matthew completed chemotherapy to treat Hodgkin's lymphoma.
"We've had a long journey this year," Lori told the Indianapolis Star.
On Black Friday the Diehls were shopping with gift cards they had received from family friends and congregants at their church in Shelbyville, Ind. One can only imagine the horrifying feeling of returning to a car, once full of Christmas gifts bought on donated money, and seeing it empty.
"We had struggled this year and people will never know how much of a blessing they were to reach out to us," Lori told the Star. "Somehow, I felt like I had let all of them down. I was just devastated."
After seeing the Diehls' story on television, Megan McGlynn told Mike, who's in his first year with Indianapolis. Mike asked the Colts to get in touch with the Diehls, and when they did, he gave the family some much-needed good news: He would refund everything they lost, about $500 worth of gifts.
"I made a little donation to her and her family, just to make the Christmas time better," McGlynn told the Star.
McGlynn called the Diehls after the Colts' win over the Buffalo Bills on Sunday, and he said their 3-year-old son, Brayden, was "over the moon excited" to speak with him.
"We're so blessed in here, what we're doing right now," McGlynn said. "To see somebody who has something happen, everybody works hard for their money, everybody works hard for whatever they can get. To have it taken away is just the wrong thing."
McGlynn wasn't the only one who chipped in. Lori's breast pump was stolen along with the Christmas presents on Black Friday, so the police officer who responded to Lori's original 9-1-1 call donated her old breast pump.
Lori told WISH TV that the overwhelming show of support has itself been a lesson for her children.
"They took the time and really helped us show our children that even in times of adversity there are good people out there," Lori said. "We hope if somebody hears our story, they could bless someone else and find somebody in their life they could reach out to. Just the difference it can make, even if it's just a small gesture."
(H/T to Off the Bench)


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A little while back I had mentioned here that I wanted to make these pots. They are called hypertufa pots and were sooooo easy to make. I love how they turned out. The tutorial was easy to follow just click on that link and it will take you through step by step. I have alot of extra ingredients to make a ton more. The key is collecting the right containers for the molds.
I just put some organic basil in there.
All in all a great project! Go make some!!!


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Lake of Fire2007
Lake of Fire (2007)
Critic Consensus: Lake of Fire's engaging interviews and powerful black-and-white visuals make for a riveting and honest documentary about a very controversial topic.
Lake of Fire Photos
Movie Info
News & Interviews for Lake of Fire
Critic Reviews for Lake of Fire
All Critics (54) | Top Critics (22) | Fresh (51) | Rotten (3) | DVD (1)
When the focus narrows to the personal, the film becomes undeniably powerful in its specifics.
You may not leave the theater having switched sides, but you'll probably respect the other side more, and that in itself would be a victory for human life.
For all its provocativeness, Lake of Fire is not a shapeless movie, nor a politically irresponsible one.
At 152 minutes, his film doesn't seem long, because at every moment something absorbing, disturbing, depressing or infuriating is happening.
No one will have an easy time of it with Lake of Fire, a work of profound anguish centered on the abortion rights debate.
Lake of Fire does something with the volatile subject of abortion that neutral observers and even political partisans can appreciate: It offers a wide representation of perspectives and opinions.
Audience Reviews for Lake of Fire
Lake of Fire is graphic documentary on abortion directed by Tony Kaye (American History X, Detachment). It's journalistic reporting showing both sides. The interviews are with doctors, rednecks, and everything in between. It showed graphic images of legal and back alley abortions, that disturbs anyone on either sides. I'm still pro-choice and pro-life people will still be pro-life. It's more historical than scientific, which is fine, but I didn't learn many new facts. Also the run time is too long at 152 minutes, in that amount of time everything got repetitive and already said.
Super Reviewer
'Lake of Fire' is incredibly difficult to watch at moments, specifically the images of the abortion process or pictures of women who unsuccessfully tried to perform an abortion on themselves, but its one of the best documentaries I've ever seen. It shows the wide range of beliefs pretty favorably ranging from sane to crazy and while it slightly leans in favor of the pro-choice movement, its still one of the most unbiased portrayals of the abortion issue that any filmmaker has dared to make. The most important thing that the film shows us is that Americans have a very hard time with rational debate and discussion regardless of their opinion or political affiliation.
Super Reviewer
An epic, nearly 3 hour documentary spanning over the course of 15 years about the highly controversial subject of abortion. It doesn't shy away from difficult-to-look-at images: it shows an actual abortion taking place as well as the remains of the aborted 5-month old fetus, it shows the bodies of Doctors gunned down by fanatics, and it shows pictures of the bodies of women who tried to give themselves "coat hanger abortions". Let me get back to the abortion shown, it's graphic and pretty hard to take, and yet, anyone who's pro-choice needs to see this and then ask themselves if they still feel the same. It takes all denial out of the supporters mind, they can't pretend it's "just a mass of cells" anymore. So, the question is no longer, "is it a human life?" or "is it a baby?", but what are the consequences of this child being born how will society deal with it? The film points out the hypocrisy of conservatives who in one breath will condemn abortion but in the other vote against sex education, birth control and welfare programs (apparently they're only concerned with babies before they're born). Being against birth control is an especially telling sign showing that many who are pro-life are more importantly anti-sex. Of course the film also focuses on the fanatical who whip their followers into a frenzy, and the consequences of that frenzy when one of their followers is unstable, showing the murder of Dr. Gunn among others. Of course, Doctor killers and fire bombers are a fringe group, but it's amazing how far-reaching their influence can be (when they show pictures of republican presidents with those who would later kill, it's especially chilling). Abortion is never painted in a glamorous light, and it's certainly not enjoyable for a woman to go through one. It's something no woman goes into lightly. "Lake of Fire" doesn't settle any arguments, it makes them and lets the viewer decide.
Super Reviewer
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There are no approved quotes yet for this movie.