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Drug-Resistant Hyponatremia after Escitalopram Intake: A Series of Two Case Reports

机译:艾司西酞普兰摄入后耐药性低钠血症:2 例病例系列

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摘要

The consumption of new selective serotonin reuptake inhibitors (SSRIs) is raising dramatically especially in European countries. It contributes to occurrence of clinically important drug side effects. One of which can be hyponatremia. We present two case reports of 85-year-old and 84-year-old women who developed hyponatremia after escitalopram administration. We hypothesize that in both cases hyponatremia was connected with antidepressants administration. However, due to multiple comorbidities and polypharmacy it is often impossible to establish the exact mechanism of hyponatremia. Moreover, it is crucial to distinguish subtypes of drug-induced syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH), such as SSRI-induced SIADH, reset osmostat SIADH, thiazide-associated hyponatremia, thiazide-induced hyponatremia, mineralocorticoid responsive hyponatremia of older adults, in order to properly diagnose and treat geriatric patients. Administration of antidepressants or thiazides should be followed by a regular monitoring of serum sodium level.
机译:新的选择性血清素再摄取抑制剂 (SSRIs) 的消费量正在急剧增加,尤其是在欧洲国家。它会导致临床上重要的药物副作用的发生。其中之一可能是低钠血症。我们提出了两例 85 岁和 84 岁女性在艾司西酞普兰给药后出现低钠血症的病例报告。我们假设在这两种情况下,低钠血症都与抗抑郁药的给药有关。然而,由于多种合并症和多药治疗,通常无法确定低钠血症的确切机制。此外,区分药物诱导的抗利尿激素分泌异常综合征 (SIADH) 的亚型至关重要,例如 SSRI 诱导的 SIADH、渗透压复位 SIADH、噻嗪类药物相关低钠血症、噻嗪类药物诱导的低钠血症、盐皮质激素反应性老年人低钠血症,以便正确诊断和治疗老年患者。服用抗抑郁药或噻嗪类药物后,应定期监测血清钠水平。

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