Thiazide Diuretics Induced Severe Hyponatremi...

Thiazide Diuretics Induced Severe Hyponatremia: A Case Report

Author Name : Gayathri Konduri, Priyanka Kasala, Srinivas Sattu

ABSTRACT

Hyonatremia is defined as the decreased sodium concentration in the body. Diuretics are the class of drugs which inhibit the reabsorption of sodium in the nephron. Thiazide diuretics act by blocking of the sodium-chloride (Na/Cl) channel in the proximal segment of the distal convoluted tubule (DCT). Commonly used thiazide diuretics include Indapamide, hydrochlorthiazide, indapamide. Common adverse effects of diuretics include hypokalemia, hyponatremia, metabolic acidosis, hypercalcemia, hyperglycemia, hyperuricemia, hyperlipidemia. This case report describes a case of a 61 years old male patient who had complaints of low grade, intermittent fever associated with chills since 5 days, shortness of breath grade-1 since 2 days increased on exertion. Patient is hypertensive since 20 years and is on T. Olmesartan 40mg+ Cilindipine 10mg+ chlorthalidone 12.5mg OD. The patient developed hyponatremia where sodium levels were low and had altered sensorium. Thiazide diuretics i.e. chlorthalidone was suspected as the cause of the ADR and the drug was stopped. The patient’s sodium levels improved and the patient was also given T. Tolvaptan which is a vasopressin receptor inhibitor and helps in the treatment of hyponatremia. The hypertensive medications were replaced with T. Amlodipine and T. Telmisartan. Diuretics are most commonly used drugs in the treatment of hypertension. However, it is vital to monitor the electrolyte levels and consider the possibilities of drug induced electrolyte imbalance. Hyponatremia and Hypokalemia can be life threatening complications in such therapy.