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]
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]
Severe hyperkalemia may present as muscle weakness, fatigue and slow heart rate ( bradycardia ). It is important to monitor potassium blood levels and to have an electrocardiogram performed. [rxlist.com]
Entire Body System
- Pain
Capsaicin (what gives cayenne its spicy flavor) is a PAIN-RELIEVER. It inhibits sensory & pain nerves, which is great for ARTHRITIS & MIGRAINES. [pinterest.de]
Your pain may be a symptom of a serious side effect, or it may be completely unrelated to HCTZ. [everydayhealth.com]
The knee pain subsided. The patient was informed about the importance of increasing fluid intake; she was discharged after 14 days in good general condition. [omicsonline.org]
As hypertension, heart failure, and conditions causing chronic pain are common in the elderly, the risk of exposure to potential interactions between these drugs increases over time. [pharmacytimes.com]
Key terms Inflammation — Pain, redness, swelling, and heat that usually develop in response to injury or illness. Lupus erythematosus — A chronic disease that affects the skin, joints, and certain internal organs. [medical-dictionary.thefreedictionary.com]
- Congestive Heart Failure
Abstract Since the introduction of novarsurol as a diuretic by Saxl and Heilig 1 in 1923, dehydration by means of the mercurial has played an important rôle in the treatment of congestive heart failure. [annals.org]
About 75 million... 12 Congestive Heart Failure Symptoms, Stages, Causes, and Life Expectancy Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease,... [medicinenet.com]
A: Benazepril is a medication that is used to treat high blood pressure, congestive heart failure, and chronic renal failure. It is in the class of medications called ACE inhibitors that work by causing blood vessels to relax. [everydayhealth.com]
Indications Loop diuretics are prescribed to treat water imbalances associated with congestive heart failure and kidney failure. Symptoms include shortness of breath as a result of water retention in the lungs and swelling of lower extremities. [brighthub.com]
Other effects: Furosemide: increases renal blood flow; blood flow redistribution within the renal cortex Furosemide decreases pulmonary congestion and the left ventricular filling pressure in congestive heart failure (CHF) -- prior to an increase in urine [pharmacology2000.com]
Respiratoric
- Sore Throat
Cayenne is ANTI-BACTERIAL, helping you fight respiratory infections, SORE THROATS, & flus. The spicy heat is detoxifying & can increase CIRCULATION & remove blockages that promote disease & illness. [pinterest.de]
Gastrointestinal
- 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]
Cardiovascular
- Heart Failure
Heart failure Heart failure leads to activation of the renin-angiotensin-aldosterone system, which causes increased sodium and water retention by the kidneys. [cvpharmacology.com]
This is particularly important for people with heart failure. [bpac.org.nz]
Chronic heart failure [ 6 ] Use the lowest dose of diuretic necessary to relieve fluid overload and breathlessness and adjust following the addition of other heart failure therapies. [patient.info]
[…] times higher than required once acute recompensation has been achieved following heart failure exacerbations. [todaysgeriatricmedicine.com]
Digoxin is considered the most widely used cardiac medicine for heart failure and irregular heart rhythm problems (ASHP 2001). [livestrong.com]
- Tachycardia
[…] with the following symptoms: hypertension, bipolar disorder ,supraventricular tachycardia,diabetes mellitus started Diuretics treatment (dosage: NA) on NS. [patientsville.com]
CHF (it causes tachycardia) *** If you have CHF or Anuria, DON’T take mannitol if you know whats good for ya! 3. THIAZIDE DIURETICS Hydrochlorothiazides Chlorothiazides THIAZIDE - 1ST DOC for HYPERTENSION. [woanchyi818.blogspot.com]
Reflexive tachycardia may be blunted by reserpine, which can cause bradycardia (and rare cases of syncope with bradycardia) in 3% of patients. [drugs.com]
[…] imbalance (depletion) due to diuretics, adverse events such as: dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, confusion, seizures, muscular fatigue, hypotension, oliguria (decreased or absent production of urine), tachycardia [rxlist.com]
Glucosuria causes a loss of hypotonic water and Na +, leading to a hypertonic state with signs of volume depletion, such as dry mucosa, hypotension, tachycardia, and decreased turgor of the skin. [en.wikipedia.org]
- Thrombosis
Duplex sonography revealed deep venous thrombosis of the popliteal vein extending to the calf. The patient was admitted to the geriatric ward and anticoagulation with low molecular weight heparin was initiated and later switched to phenprocoumon. [omicsonline.org]
Effective in preventing the recurrence of arterial thrombosis in patients with a history of MI, Transient Ischemic Attacks (TIA's), stroke, unstable angina pectoris. [kumc.edu]
Skin
- Hirsutism
Spironolactone Hormone Anti-Hirsutism Aldosterone antagonist is used in treatment of Polycystic Ovary (Stein-Levanthal Syndrome), to prevent hirsutism. Mechanism of preventing hirsutism is unknown. [kumc.edu]
Musculoskeletal
- 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]
Neurologic
- Stroke
In another study, patients with a history of stroke or transient ischemic attack had a 31% stroke risk reduction. [todaysgeriatricmedicine.com]
However, if the volume is reduced too much, stroke volume will fall because the heart will now be operating on the ascending limb of the Frank-Starling relationship. [cvpharmacology.com]
Mnemonic ''GUM'' Glycerol Urea Mannitol MANNITOL Uses: '' BCGS'' B- Barturate Poisoning C- Cerebral Edema G- Glaucoma S- Stroke /Shock C/I : ''CAP' If cerebral hemorrphage --> C/I ( as Mannitol can escape from hemorrphagic vessels & cause dehydration [woanchyi818.blogspot.com]
Some progestins are hormone deficiency states more likely to cause weight gain, acne, and changes in blood • Disturbed Body Image in men, related to feminizing effects lipids that increase risks of myocardial infarction or stroke. [thebakersfieldfox.com]
When chosen as a treatment for hypertension, diuretics have proven to be effective in preventing heart attack and stroke in many individuals. [healthline.com]
- Agitation
Even a moderate potassium change can induce digoxin toxicity; symptoms of toxicity include agitation, hallucinations, dizziness, nausea and blurry vision. [livestrong.com]
Urogenital
- 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]
Workup
Serum
- Hyponatremia
hypermagnesemia, hyponatremia Hyperkalemia, hyperuricemia, hypoglycemia, hypomagnesemia, hyponatremia 3. [lecturio.com]
Toxicity: hypokalemic metabolic alkalosis, hyponatremia; hyperGlycemia, hyperLipidemia, hyperUricemia & hyperCalcemia (hyperGLUC). Sulfa allergy. [quizlet.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]
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]
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]
(Scrophulariaceae) is a perennial plant used in folk medicine for the treatment of kidney diseases due to its presumable diuretic properties. [ncbi.nlm.nih.gov]
Initiating loop diuretics or ACE inhibitors significantly increased the risk of lithium toxicity: within one month of starting treatment. [ebmh.bmj.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]
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
[…] 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]
Abolishes hypertonicityof medulla, preventing concentration of urine. ↑ Ca 2+excretion. Use: edematous state (CHF, cirrhosis, nephroticsyndrome, pulm. edema), HTN & hypercalcemia. [quizlet.com]
It helps prevent the body from absorbing too much salt, which can cause fluid retention. [everydayhealth.com]