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Indapamide is contraindicated in known hypersensitivity to sulfonamides, severe kidney failure, hepatic encephalopathy or severe liver failure, and a low blood potassium level. [citation needed] There is insufficient safety data to recommend indapamide use in pregnancy or breastfeeding. [citation needed]
Neurological symptoms typically occur with very low levels of plasma sodium (usually <115 mmol/L). [1] When sodium levels in the blood become very low, water enters the brain cells and causes them to swell (cerebral edema). This results in increased pressure in the skull and causes hyponatremic encephalopathy.
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.
Unsuppressed ADH causes a physiologically inappropriate increase in solute-free water being reabsorbed by the tubules of the kidney to the venous circulation leading to hypotonic hyponatremia (a low plasma osmolality and low sodium levels). [2] The causes of SIADH are commonly grouped into categories including: central nervous system diseases ...
Pseudohyponatremia is a false low sodium reading that can be caused by high levels of fats or proteins in the blood. [14] [3] Dilutional hyponatremia can happen in diabetics as high glucose levels pull water into the blood stream causing the sodium concentration to be lower.
[1] [2] Low blood protein levels can result in a falsely high sodium measurement. [4] The cause can usually be determined by the history of events. [1] Testing the urine can help if the cause is unclear. [1] The underlying mechanism typically involves too little free water in the body. [6]
Using a fixed combination of an ACE inhibitor and a chlorosulfamoyl diuretic leads to additive synergy of the antihypertensive effects of the two constituents. Its pharmacological properties are derived from those of each of the components taken separately, in addition to those due to the additive synergistic action of the two constituents, when combined, on vascular endothelium ...
Sodium is also important in regulating the amount of water that passes through the blood–brain barrier. Decreased sodium blood levels result in increased permeability of water across the blood–brain barrier. [8] This increased influx of water causes brain swelling which leads to severe neurological symptoms. [8]