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Hyponatremia-Inducing Drugs.

George Liamis, Efstathia Megapanou, Moses Elisaf

    Frontiers of Hormone Research
    |February 26, 2020
    PubMed
    Summary
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    Many common medications can cause hyponatremia, a condition of low serum sodium. Identifying and discontinuing these drugs is crucial to prevent adverse outcomes like falls and mortality.

    Area of Science:

    • Clinical Pharmacology
    • Nephrology
    • Endocrinology

    Background:

    • Hyponatremia, a common electrolyte imbalance, can result from various medications.
    • Certain drug classes, including diuretics, psychotropic drugs, and anticonvulsants, are frequently implicated.
    • Other commonly prescribed drugs may also contribute, albeit less frequently.

    Purpose of the Study:

    • To highlight the association between pharmacotherapy and hyponatremia.
    • To emphasize the importance of recognizing drug-induced hyponatremia in clinical practice.
    • To underscore the need for careful medication review in patients with low serum sodium.

    Main Methods:

    • Review of clinical literature on drug-induced hyponatremia.
    • Analysis of mechanisms by which drugs affect sodium and water homeostasis.

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  • Clinical case considerations for diagnostic approaches.

    • Main Results:

    • Diuretics, psychotropic drugs, and anticonvulsants are common causes of hyponatremia.
    • Proton pump inhibitors, antibiotics, ACE inhibitors, hypoglycemic agents, and amiodarone are less frequently associated.
    • Drug-induced hyponatremia can result from altered sodium-water balance or syndrome of inappropriate antidiuretic hormone secretion.

    Conclusions:

    • Meticulous patient history and pharmacotherapy review are essential for diagnosing hyponatremia.
    • Recognizing drug-induced hyponatremia is vital due to associated adverse outcomes, including impaired cognition, falls, fractures, and mortality.
    • Discontinuation of causative agents and avoidance of re-challenge are recommended, with patient and caregiver education.