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Antipsychotics have been reported to cause hyponatremia in a review of medical articles from 1946 to 2016. [25] Available evidence suggests that all classes of psychotropics, i.e., antidepressants, antipsychotics, mood stabilizers, and sedative/hypnotics can lead to hyponatremia. Age is a significant factor for drug induced hyponatremia. [26]
The low GFR causes a lowered rate of osmole excretion, and an increase in the amount of water reabsorbed; thus, hyponatremia occurs when the amount of water intake exceeds the renal water excretion capacity. [2] Medications, such as thiazides and antidepressants, may exacerbate symptoms of hyponatremia. [2]
In severe or acute hypoosmolar hyponatremia, swelling of brain cells causes various neurological abnormalities, which in severe or acute cases can result in convulsions, coma, and death. The symptoms of chronic syndrome of inappropriate antidiuresis are more vague, and may include cognitive impairment , gait abnormalities , or osteoporosis .
Symptoms of hypernatremia may vary depending on type and how quickly the electrolyte disturbance developed. [27] Common symptoms are dehydration, nausea, vomiting, fatigue, weakness, increased thirst, and excess urination. Patients may be on medications that caused the imbalance such as diuretics or nonsteroidal anti-inflammatory drugs. [27]
Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used. [2] When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.
Signs and symptoms of psychogenic polydipsia include: [3] Excessive thirst and xerostomia, leading to overconsumption of water; Hyponatraemia, causing headache, muscular weakness, twitching, confusion, vomiting, irritability etc., although this is only seen in 20–30% of cases.
The "vaptan" drugs act by directly blocking the action of vasopressin at its receptors (V 1A, V 1B and V 2).These receptors have a variety of functions, with the V 1A and V 2 receptors are expressed peripherally and involved in the modulation of blood pressure and kidney function respectively, while the V 1A and V 1B receptors are expressed in the central nervous system.
Less common side effects of chlorpropamide include gastrointestinal symptoms such as nausea, vomiting, and diarrhea. [2] It may cause facial flushing after the ingestion of alcohol. [3] In very high doses it can increase secretion of antidiuretic hormone (ADH), which can lead to hyponatremia. [1]