Hyponatraemia during treatment with chlorpropamide and Moduretic (amiloride plus hydrochlorothiazide).

Zalin, A. M.; Hutchinson, Claire; Jong, Mark H. de; Matthews, Katherine

doi:10.1136/bmj.289.6446.659

Cited by 12 publications

(2 citation statements)

References 3 publications

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“…After exclusion of duplicates and articles where data were non‐human or irrelevant to thiazide‐induced hyponatraemia in adults, 102 articles remained (median date of publication was 1998, range 1962–2013) and were analyzed (Figure ). Of the 102 articles analyzed, 49 were single case reports (Table S1) and the remaining 52 articles ranged from two to 1802 patients (Table S2). Four papers were also removed because the same study population was already represented in the 102 articles included in the review .…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis of thiazide‐induced hyponatraemia: time to reconsider electrolyte monitoring regimens after thiazide initiation?

Barber

McKeever

McDowell

et al. 2015

Brit J Clinical Pharma

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AimsHyponatraemia is one of the major adverse effects of thiazide and thiazide-like diuretics and the leading cause of drug-induced hyponatraemia requiring hospital admission. We sought to review and analyze all published cases of this important condition.MethodsOvid Medline, Embase, Web of Science and PubMed electronic databases were searched to identify all relevant articles published before October 2013. A proportions meta-analysis was undertaken.ResultsOne hundred and two articles were identified of which 49 were single patient case reports. Meta-analysis showed that mean age was 75 (95% CI 73, 77) years, 79% were women (95% CI 74, 82) and mean body mass index was 25 (95% CI 20, 30) kg m−2. Presentation with thiazide-induced hyponatraemia occurred a mean of 19 (95% CI 8, 30) days after starting treatment, with mean trough serum sodium concentration of 116 (95% CI 113, 120) mm and serum potassium of 3.3 (95% CI 3.0, 3.5) mm. Mean urinary sodium concentration was 64 mm (95% CI 47, 81). The most frequently reported drugs were hydrochlorothiazide, indapamide and bendroflumethiazide.ConclusionsPatients with thiazide-induced hyponatraemia were characterized by advanced age, female gender, inappropriate saliuresis and mild hypokalaemia. Low BMI was not found to be a significant risk factor, despite previous suggestions. The time from thiazide initiation to presentation with hyponatraemia suggests that the recommended practice of performing a single investigation of serum biochemistry 7–14 days after thiazide initiation may be insufficient or suboptimal. Further larger and more systematic studies of thiazide-induced hyponatraemia are required.

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Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis of thiazide‐induced hyponatraemia: time to reconsider electrolyte monitoring regimens after thiazide initiation?

Barber

McKeever

McDowell

et al. 2015

Brit J Clinical Pharma

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“…Sulfonylurea agents were also described as medicines able to rarely cause dermatologic side effects, for example erythroderma and photosensitivity. Furthermore chlorpropamide is able to lower serum sodium concentration and its combination with Moduretic (amiloride plus hydrochlorothiazide) can lead to even greater risk of hyponatremia [24]. There have also been reports of possible hepatotoxicity of glimepiride including hepatitis with cholestasis [25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Case report - sulfonylurea poisoning mimicking vertebrobasilar acute ischemic stroke

KĘDRA

Izabela

OLESZKO

et al. 2023

J Educ Health Sport

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Background: We report the case of sulfonylurea induced hypoglycemia manifesting as acute encephalopathy with focal neurological signs misdiagnosed as posterior circulation acute ischemic stroke (AIS) and discuss the potential effects of hypoglycemia on central nervous system, as well as its differentiation from AIS. Case presentation: A 64-year-old patient with type II diabetes treated with glimepiride was transferred to the Department of Neurology after the procedure of radical prostatectomy. On admission, the patient was unconscious with four limb paresis and bilateral Babinski sign. Non-contrast head CT and CT angiography vessels did not reveal any abnormalities. Due to exceeded therapeutic window the patient was disqualified from intravenous thrombolysis. At the admission hypoglycemia was observed and promptly corrected with the 5% dextrose infusion. For the next 72 hours repeated intravenous glucose infusions were needed to maintain its levels above 70 mg/dl. Based on the absence of ischemic changes on MRI and repeated decreases in glucose level for the next 3 days, glimepiride induced hypoglycemic encephalopathy was diagnosed. Within 24 hours of admission the patient regained consciousness and eventually presented four-limb paresis as a result of prolonged neuroglycopenia. Conclusions: Prolonged insufficient brain nutrition can result in permanent or long-lasting brain damage, manifesting as impaired consciousness and focal neurological signs. Perioperative sulfonylureas intake may result in prolonged hypoglycemia.

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Hyponatraemia in the elderly patient

Solomon

Sangster

Lye

1992

Geriatric Nephrol Urol

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Hyponatraemia during treatment with chlorpropamide and Moduretic (amiloride plus hydrochlorothiazide).

Cited by 12 publications

References 3 publications

A systematic review and meta‐analysis of thiazide‐induced hyponatraemia: time to reconsider electrolyte monitoring regimens after thiazide initiation?

A systematic review and meta‐analysis of thiazide‐induced hyponatraemia: time to reconsider electrolyte monitoring regimens after thiazide initiation?

Case report - sulfonylurea poisoning mimicking vertebrobasilar acute ischemic stroke

Hyponatraemia in the elderly patient

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