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Diuretic Toxicity


Presentation

  • Psychiatry and Mental health Cite this Apa Standard Harvard Vancouver BIBTEX RIS @article{7377de3248a6400e89470e6639ff2efb, title "Diuretic-Induced lithium toxicity presenting as Mania", abstract "A bipolar patient receiving lithium therapy developed[indiana.pure.elsevier.com]
  • The patient presented with: Dizziness Hot Flush Hypotension Toxicity To Various Agents Vomiting Nausea Dehydration Asthenia which developed after the beginning of treatment. The patient was hospitalized.[patientsville.com]
  • Present in vivo study was made to investigate the acute toxicity and diuretic activity of chloroform and ethanolic extract of leaves of Clerodendrum inerm. Male Albino Wistar rats (150-250 g) were taken for the study.[agris.fao.org]
  • The aim of the present study was to explore the diuretic activity of the aqueous extract of C. nitida seed (AECONS) and alteration caused by its subchronic administration on the structure and function of the kidney of male Wistar rats.[bioportfolio.com]
  • Case 3 An 87-year-old male patient presented in the emergency ward with a painful head injury. He reported having been greatly startled, which precipitated the fall from a sitting position.[omicsonline.org]
Virilization
  • Spironolactone has anti-androgenic effects, including incomplete virilization of the male fetus. Diuretics should be used cautiously in pregnancy.[www2.kidney.org]
Aspiration
  • Soon after starting Diuretics treatment, the consumer experienced several side effects, including: Neurotoxicity Acute Respiratory Distress Syndrome Coma Supraventricular Tachycardia Dehydration Pneumonia Aspiration Electroencephalogram Abnormal Toxicity[patientsville.com]
  • Adverse Effects: (1) bowel granulomas, (2) may cause aspiration pneumonia in infants, (3) leaks through the anal sphincter, (4) interferes with absorption of fat-soluble vitamins Glycerine Suppositories GI; Laxative Miscellaneous Promote peristalsis by[kumc.edu]
Respiratory Distress
  • Soon after starting Diuretics treatment, the consumer experienced several side effects, including: Neurotoxicity Acute Respiratory Distress Syndrome Coma Supraventricular Tachycardia Dehydration Pneumonia Aspiration Electroencephalogram Abnormal Toxicity[patientsville.com]
Polydipsia
  • Early symptoms of hypercalcemia may include nausea, vomiting, and anorexia (appetite/weight loss), followed by polyuria (excess urination), polydipsia (excess thirst), weakness, fatigue, somnolence, headache, dry mouth, metallic taste, vertigo, tinnitus[vitamindwiki.com]
  • In addition, Li may affect water homeostasis by producing a primary polydipsia [ 23 ] and possibly by inhibiting CNS release of ADH [ 24 ].[ckj.oxfordjournals.org]
Morning Sickness
  • Cola nitida is a plant, conventionally used in Africa in the treatment of various ailments such as migraine, morning sickness and indigestion.[bioportfolio.com]
Muscle Cramp
  • The most common side effects with HCTZ are dizziness, headache, fatigue, muscle cramps, abdominal pain, and diarrhea. This is not a complete list of the side effects associated with HCTZ.[everydayhealth.com]
  • cramps or pain unusual tiredness or weakness mental or mood changes Interactions Diuretics may interact with other medicines.[medical-dictionary.thefreedictionary.com]
  • Adverse Effects: Muscle cramps, headache, constipation Nizatidine (Axid) GI; Peptic Ulcer H 2 -Blocker Adverse Effects: Minor. Greater than 90% urinary excretion, more than the other drugs.[kumc.edu]
Suggestibility
  • The initial changes in mental status suggested that the patient might be beginning another manic episode. Symptoms resolved following hemodialysis.[indiana.pure.elsevier.com]
  • The initial changes in mental status suggested that the patient might be beginning another manic episode. Symptoms resolved following hemodialysis. Williams & Wilkins 1985. All Rights Reserved. Related Articles[journals.lww.com]
  • Previous phytochemical studies suggest potentialities for the therapeutic use. The objective of this study was to evaluate the acute toxicity at single dose and the possible diuretic effect of the hydroalcoholic extract from the leaves of the plant.[jppres.com]
  • Taken at face value, this paper might indicate that thiazide diuretics and NSAIDs are relatively safe to prescribe to patients taking lithium; not that the authors actually suggest it.[ebmh.bmj.com]
  • A growing body of evidence also suggests that ACE inhibitors may impair lithium elimination, but further investigations are needed to identify patients at risk.[ncbi.nlm.nih.gov]
Polyuria
  • Of those, 30% have a subclinical concentrating defect, while the remaining 20% suffer from polyuria that can take place within the first 8–12 weeks of treatment.[ckj.oxfordjournals.org]
  • Early symptoms of hypercalcemia may include nausea, vomiting, and anorexia (appetite/weight loss), followed by polyuria (excess urination), polydipsia (excess thirst), weakness, fatigue, somnolence, headache, dry mouth, metallic taste, vertigo, tinnitus[vitamindwiki.com]
Hot Flushes
  • The patient presented with: Dizziness Hot Flush Hypotension Toxicity To Various Agents Vomiting Nausea Dehydration Asthenia which developed after the beginning of treatment. The patient was hospitalized.[patientsville.com]

Workup

Electroencephalogram Abnormal
  • Soon after starting Diuretics treatment, the consumer experienced several side effects, including: Neurotoxicity Acute Respiratory Distress Syndrome Coma Supraventricular Tachycardia Dehydration Pneumonia Aspiration Electroencephalogram Abnormal Toxicity[patientsville.com]
Hyponatremia
  • So with hyponatremia, more Li is reabsorbed causing higher Li levels and lithium toxicity. This goes for anything that causes lower na levels.[forums.studentdoctor.net]
  • Toxicity: hypokalemic metabolic alkalosis, hyponatremia; hyperGlycemia, hyperLipidemia, hyperUricemia & hyperCalcemia (hyperGLUC). Sulfa allergy.[quizlet.com]
  • , hypermagnesemia, hyponatremia Hyperkalemia, hyperuricemia, hypoglycemia, hypomagnesemia, hyponatremia 3.[lecturio.com]
  • In one study, for example, hyponatremia occurred in 17% of patients.2 The risk of hyponatremia appears to be particularly common in elderly female patients.1 Hyponatremia can lead to confusion, delirium, and irreversible brain damage that may contribute[todaysgeriatricmedicine.com]
  • Laboratory findings revealed hyponatremia ( Table 1 ) and elevated renal retention parameters pointed to acute renal failure. On the geriatric ward, she was found to be alert and responsive and spatially as well as temporally well-oriented.[omicsonline.org]
Alkaline Phosphatase Increased
  • Diabetes Mellitus, Blood Alkaline Phosphatase Increased, Toxicity To Various Agents, Nephropathy Toxic, Complications Of Transplanted Kidney This Toxicity To Various Agents side effect was reported by a health professional from JAPAN.[patientsville.com]
Calcium Increased
  • For oliguria, repeat max. effective dose as required, but no more often than every 12 hr (fullterm) or 24 hr (premature) 1 Causes major urinary loss of sodium and chloride; also potassium and calcium.[uichildrens.org]

Treatment

  • A bipolar patient receiving lithium therapy developed a toxic state with a serum lithium level of 3.9 within 2 weeks of beginning hydrochlorothiazide treatment for hypertension.[indiana.pure.elsevier.com]
  • During acute treatment, FM 100 mg kg -1 dose significantly increased the levels of AST, creatinine and urea, while CSA treatment caused increase only in AST and creatinine levels. FM treatment induced clastogenic effect p[medwelljournals.com]
  • This side effect report can indicate a possible existence of increased vulnerability to Diuretics treatment in patients suffering from NA, resulting in Toxicity To Various Agents .[patientsville.com]
  • Initiating loop diuretics or ACE inhibitors significantly increased the risk of lithium toxicity: within one month of starting treatment.[ebmh.bmj.com]
  • Cola nitida is a plant, conventionally used in Africa in the treatment of various ailments such as migraine, morning sickness and indigestion.[bioportfolio.com]

Prognosis

  • Single-center experience with drug-induced liver injury from India: causes, outcome, prognosis, and predictors of mortality. Am J Gastroenterol 2010; 105: 2396-404.[livertox.nih.gov]

Epidemiology

  • Thiazide-induced hypercalcemia can have advantages as recent epidemiological studies have shown a preservation of bone mineral density in the hip and the spine as well as a decrease in the risk of hip fracture in patients on chronic thiazide treatment[lecturio.com]
  • Acute kidney injury: epidemiology and diagnostic criteria. Curr Opin Crit Care. 2006;12(6):531–537. 6. Gandhi TK, Burstin HR, Cook EF, et al. Drug complications in outpatients. J Gen Intern Med. 2000;15(3):149–154. 7.[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • Immunosuppressant-induced nephropathy: pathophysiology, incidence and management. Drug Saf. 1999;21(6):471–488. 12. Perazella MA. Drug-induced nephropathy: an update. Expert Opin Drug Saf. 2005;4(4):689–706. 13. Markowitz GS, Perazella MA.[aafp.org]
  • Herein, we review evidence-based clinical information on the incidence of hypernatraemia associated with specific drug treatment and discuss the underlying pathophysiologic mechanisms and potential therapeutic implications.[ckj.oxfordjournals.org]
  • It is useful to think of two patterns of altered pathophysiology: Sodium retention due to decreased filtered load.[www2.kidney.org]

Prevention

  • Abolishes hypertonicityof medulla, preventing concentration of urine. Ca 2 excretion. Use: edematous state (CHF, cirrhosis, nephroticsyndrome, pulm. edema), HTN & hypercalcemia.[quizlet.com]
  • […] measures unique to some of these drugs are highlighted in Table 3. 7, 10 – 13, 20 – 24, 32, 37, 38 View/Print Table Table 3 Patient-Related Risk Factors and Specific Prevention Strategies for Selected Agents Medications Risk factors Prevention strategies[aafp.org]
  • Ethanol Toxicity It is given to displace the substrates and prevent their metabolism, in methanol and ethylene glycol poisoning. Prevent methanol from going to formic acid, and prevent ethylene glycol from going to oxalic acid.[kumc.edu]
  • It helps prevent the body from absorbing too much salt, which can cause fluid retention.[everydayhealth.com]

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