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Elderly patients may present in any of these volume states. However, "tea and toast" syndrome patients typically present euvolemic hyponatremia since their hyponatremia is caused by low solute intake. These patients must receive proper nutrition that is higher in protein and electrolyte intake. [15]
Antipsychotics have been reported to cause hyponatremia in a review of medical articles from 1946 to 2016. [25] Available evidence suggests that all classes of psychotropics, i.e., antidepressants, antipsychotics, mood stabilizers, and sedative/hypnotics can lead to hyponatremia. Age is a significant factor for drug induced hyponatremia.
[14] [3] Dilutional hyponatremia can happen in diabetics as high glucose levels pull water into the blood stream causing the sodium concentration to be lower. [14] [3] Diagnosis of the cause of hyponatremia relies on three factors: volume status, plasma osmolality, urine sodium levels and urine osmolality. [14] [3]
In severe or acute hypoosmolar hyponatremia, swelling of brain cells causes various neurological abnormalities, which in severe or acute cases can result in convulsions, coma, and death. The symptoms of chronic syndrome of inappropriate antidiuresis are more vague, and may include cognitive impairment , gait abnormalities , or osteoporosis .
Reducing fluid intake can alleviate stress on the body and may reduce additional complications. A fluid restriction diet is generally medically advised for patients with "heart problems, renal disease, liver damage including cirrhosis , endocrine and adrenal gland issues, elevated stress hormones and hyponatremia". [ 1 ]
Patients can have increased BUN and serum creatinine as a result of pre-renal kidney failure. Hypernatremia or hyponatremia can result, as can hyperkalemia or hypokalemia. [4] Lactic acidosis can result from increased anaerobic metabolism. However, the effect of acid–base balance can be variable as patients with large GI losses can become ...
Hypoosmolar hyponatremia is a condition where hyponatremia is associated with a low plasma osmolality. [1] The term "hypotonic hyponatremia" is also sometimes used. [2] When the plasma osmolarity is low, the extracellular fluid volume status may be in one of three states: low volume, normal volume, or high volume.
Mirtazapine is known to cause hyponatremia in some patients and is therefore is a potential slow sodium channel blocker with cardiac symptoms typically appearing around a month after treatment, it just isn't a "fast" sodium channel blocker. This is from one of many peer reviewed journals that actually bother to include Mirtazapine in safety ...