Hyponatraemia during Oxcarbazepine Therapy

1989 ◽  
Vol 8 (5) ◽  
pp. 337-344 ◽  
Author(s):  
S.C. Pendlebury ◽  
D.K. Moses ◽  
M.J. Eadie
Keyword(s):  
Adverse Effect ◽  
Sodium Level ◽  
Seizure Control ◽  
Fluid Intake ◽  
Refractory Epilepsy ◽  
Plasma Sodium ◽  
Plasma Sodium Level ◽  
The Mean ◽  
Dose Dependent

A clinical and pharmacokinetic study was carried out progressively substituting a new anticonvulsant oxcarbazepine for its congener carbamazepine in a group of patients with refractory epilepsy. Although oxcarbazepine showed possible though not statistically significant advantages of better seizure control and was probably less sedating, its use was associated with a dose-dependent reduction in plasma sodium levels in 12 of 15 patients. The mean plasma sodium level fell from 137.5 ± 5.2 (s.d.) to 128.5 ± 6.1 mE/1. Imposed restriction of fluid intake may have minimized the degree of hyponatraemia. This adverse effect may limit the role of the drug as an anticonvulsant or necessitate special precautions when it is used. However, the possibility of employing the drug in diabetes insipidus may be worth exploring.

PATHOGENESIS OF SEIZURES OCCURRING DURING RESTORATION OF PLASMA TONICITY TO NORMAL IN ANIMALS PREVIOUSLY CHRONICALLY HYPERNATREMIC

PEDIATRICS ◽  
1969 ◽  
Vol 43 (1) ◽  
pp. 54-64
Author(s):  
Gwendolyn R. Hogan ◽  
Philip R. Dodge ◽  
Sheila R. Gill ◽  
Susan Master ◽  
Juan F. Sotos
Keyword(s):  
Sodium Chloride ◽  
Water Content ◽  
Nasogastric Tube ◽  
Chloride Solution ◽  
Sodium Chloride Solution ◽  
Sodium Level ◽  
Plasma Sodium ◽  
Plasma Sodium Level ◽  
The Mean ◽  
The Brain

The present study describes the results of rehydration of rabbits rendered chronically hypernatremic by the administration of one molar sodium chloride solution by nasogastric tube for 23½ to 5 days. When these animals were rehydrated intravenously over a 4-hour period with 2.5% dextrose in water, returning the plasma sodium level to normal, 55% of them developed focal or generalized convulsions. The mean water content of brain tissue of the group of animals who had seizures was significantly greater than that of a normal group of animals and comparable to that found in a water-intoxicated group of animals. This elevation of water content could be accounted for by both an elevated content of potassium and chloride in the brain. The potassium content of the brain was higher in the rehydrated group of animals without than those with seizures. Ways by which the observed changes may be related to the development of seizures are discussed.

scholarly journals A comparative analysis of hydrochlorothiazide and chlorthalidone induced hyponatremia at the dose commonly prescribed in clinical practice

2018 ◽  
Vol 7 (5) ◽  
pp. 935
Author(s):  
Sura Kishore Mishra ◽  
Abinash Panda
Keyword(s):  
Sodium Level ◽  
Dose Range ◽  
Treated Group ◽  
Relative Difference ◽  
Cross Sectional Study ◽  
Plasma Sodium ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Treatment Of Hypertension ◽  
Plasma Sodium Level

Background: Despite the differences in cardiovascular outcomes, pharmacokinetics, pharmacodynamics, the diuretics, chlorthalidone (CTD) and hydrochlorothiazide (HCTZ) are often considered as interchangeable. There is an on-going debate whether CTD should be preferred over HCTZ, because it appears to be more effective in the prevention of cardiovascular events. The relative difference in the incidence of hypokalemia and hyponatremia, is also a topic of debate. With this background, the study was carried out to compare the prevalence of hyponatremia between CTD and HCTZ used in the treatment of hypertension at the dose commonly prescribed in clinical practice.Methods: This was a cross sectional study carried out on a convenience sample of 74 adult patients with provisional diagnosis of hyponatremia or with a plasma sodium level of less than 135mmol/L and having a history of anti-hypertensive use of HTCZ or CTD in the dose range of 12.5-25mg/day and 6.25-12.5mg/day respectively. Chi square test and independent samples ‘t’ test were used analyse the results in GraphPad Prism 6.0.Results: HCTZ was found to be the preferred diuretic in hypertension, whereas CTD was preferred in the age group of 65-74 years. The symptoms indicative of hyponatremia as well as a lower plasma sodium level were more common in the HTCZ treated group. Patients of hypertension using CTD were less predisposed to hyponatremia (OR 0.804, 95% CI 0.207-3.12).Conclusions: Chlorthalidone, when used at a lower dose of 6.25-12.5mg/day for the treatment of hypertension cause a lesser risk of hyponatremia than hydrochlorothiazide.

scholarly journals Plasma Sodium Level Is Associated With Bone Loss Severity in Women With Anorexia Nervosa

2012 ◽  
Vol 73 (11) ◽  
pp. e1379-e1383 ◽  
Author(s):  
Elizabeth A. Lawson ◽  
Pouneh K. Fazeli ◽  
Genevieve Calder ◽  
Hannah Putnam ◽  
Madhusmita Misra ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bone Loss ◽  
Sodium Level ◽  
Plasma Sodium ◽  
Plasma Sodium Level ◽  
Loss Severity

scholarly journals Effect of γ-ethyl-γ-phenyl-butyrolactone (EFBL), anticonvulsant and hypnotic drug, on mouse brain catecholamine levels

2017 ◽  
Vol 67 (2) ◽  
pp. 215-226 ◽  
Author(s):  
Lourdes A. Vega Rasgado ◽  
Iván Villanueva ◽  
Fernando Vega Díaz
Keyword(s):  
Seizure Activity ◽  
Refractory Epilepsy ◽  
Aminooxyacetic Acid ◽  
Dependent Manner ◽  
Dopaminergic Receptors ◽  
Hypnotic Drug ◽  
Brain Levels ◽  
Dose Dependent ◽  
The Brain

Abstractγ-Ethyl-γ-phenyl-butyrolactone (EFBL) is a structural combination of the anticonvulsant γ-hydroxy-γ-ethyl-γ-phenylbutyramide (HEPB) and the hypnotic γ-butyrolactone (GBL), which inherits both properties. To clarify its mechanism of action, the effects of EFBL, GBL and HEPB on dopamine (DA) and noradrenaline (NA) brain levels were investigated. Influences of chlorpromazine, phenelzine and aminooxyacetic acid were also studied. EFBL increased DA in a dose-dependent manner, remaining enhanced by 80 % over a period of 24 h and augmented NA by 54 % one hour after treatment. HEPB increased DA and NA approximately 2-fold after the first hour. GBL raised DA and NA after three and 24 h, resp. EFBL reversed chlorpromazine effects but potentiated those of phenelzine on DA. Amino-oxyacetic modified neither DA nor NA brain levels, not even in the presence of EFBL. The anticonvulsant and hypnotic properties of EFBL are attributed to its effect on presynaptic dopaminergic receptors and its lasting effect on ethyl and phenyl radicals that hinder its degradation. The results support the role of DA and NA in regulating seizure activity in the brain and indicate that EFBL offers a potential treatment for refractory epilepsy without complementary drugs and Parkinson’s disease, without the drawbacks of oral therapies.

scholarly journals Hypernatremia post hydatid cyst resection: case report

2021 ◽  
Vol 8 (2) ◽  
pp. 726
Author(s):  
S. P. Sharma ◽  
Nishant Pathak ◽  
Ritu Grewal ◽  
Anuj Singh
Keyword(s):  
Hydatid Cyst ◽  
Hypertonic Saline ◽  
Sodium Level ◽  
Tertiary Care ◽  
Plasma Sodium ◽  
Care Hospital ◽  
Plasma Sodium Level ◽  
Scolicidal Agent ◽  
High Level ◽  
Clinical Conditions

Hypernatremia or increased sodium level is defined as the plasma sodium level over 145 m mol/l. The electrolyte abnormality is associated with severe mortality (40-60%). Patients presenting acutely with this entity have varied clinical spectrum ranging from unresponsive state, dysphagia, shortness of breath, vomiting to seizures, coma or to even death. Iatrogenic hypernatremia usually a rare entity ensues after usage of hypertonic saline as scolicidal agent during hydatid cyst resection surgeries. There is a need of high level of suspicion, to be maintained in all patients being managed for clinical conditions requiring use of hypertonic saline (3-20% NS). Here we present a case of iatrogenic hypernatremia, post-surgical resection of hydatid cyst, with clinical manifestation and subsequent management in our tertiary care hospital.

Antinociceptive Properties of Protein C in a Model of Inflammatory Hyperalgesia in Rats

1995 ◽  
Vol 73 (02) ◽  
pp. 252-255 ◽  
Author(s):  
L Pichler ◽  
W Schramm ◽  
W Ulrich ◽  
K Varadi ◽  
H P Schwarz
Keyword(s):  
Inflammatory Pain ◽  
Protein C ◽  
Pain Threshold ◽  
Antinociceptive Effect ◽  
Pretreatment Level ◽  
Intraplantar Injection ◽  
Inflammatory Hyperalgesia ◽  
The Mean ◽  
Dose Dependent

SummaryWe investigated the role of human protein C in an animal model of inflammatory hyperalgesia. Pain was induced by intraplantar injection of carrageenan (3 mg) into the hind paw of rats. The pain threshold was measured by exerting increasing amounts of pressure (in mmHg) on the paw until a struggle reaction was observed. Protein C (8-800 IU/kg) was administered intravenously immediately after carrageenan. Controls received either intraplantar injections of saline (100 µ1) instead of carrageenan or carrageenan alone. Effects on pain threshold were expressed in percent of the pretreatment value. Carrageenan alone lowered the mean pain threshold after 3 h to 33.2 ± 2.2% of the pretreatment level. Addition of protein C resulted in a dose-dependent rise in pain threshold towards the level observed in control animals treated with saline instead of carrageenan (pain threshold after 800 IU/kg protein C = 62.9 ± 2.3% of pretreatment level), demonstrating an antinociceptive effect. Protein C had no effect in animals not preconditioned with intraplantar carrageenan. Thus protein C clearly antagonized the inflammatory pain induced by carrageenan. The antinociceptive action of protein C was antagonized by injection of a monoclonal antibody against protein C, providing additional evidence that the effect was protein C-mediated.

Role of nitric oxide in fasting gastric fundus tone and in 5-HT1 receptor-mediated relaxation of gastric fundus

1999 ◽  
Vol 276 (2) ◽  
pp. G373-G377 ◽  
Author(s):  
Bernard Coulie ◽  
Jan Tack ◽  
Daniel Sifrim ◽  
Antonius Andrioli ◽  
Jozef Janssens
Keyword(s):  
Nitric Oxide ◽  
Methyl Ester ◽  
Receptor Activation ◽  
Gastric Fundus ◽  
The Mean ◽  
Change In Mean ◽  
Dose Dependent ◽  
Relaxing Effect ◽  
Prior Administration

Fasting gastric fundus tone is maintained by continuous cholinergic input. 5-Hydroxytryptamine-1 (5-HT1) receptor activation decreases gastric fundus tone in humans. Whether this fundus-relaxing effect is mediated via inhibition of cholinergic input or via activation of a nitrergic pathway is unknown. The aim of the present study was to determine the effect of nitrergic inhibition on feline gastric fundus tone and on 5-HT1receptor-mediated relaxation of the fundus. Administration of N ω-nitro-l-arginine methyl ester (l-NAME) alone caused a significant decrease of the mean baseline volume ( P < 0.005), which was restored completely by addition ofl-arginine. Sumatriptan caused a dose-dependent relaxation of the gastric fundus ( P < 0.0005). This relaxation was inhibited by l-NAME ( P < 0.02) and was restored by prior administration of l-arginine. Buspirone did not cause any change in mean baseline volume, whereas the sumatriptan-induced relaxation was not affected by prior administration of NAN-190. Our data indicate that fasting fundus tone relies not only on continuous cholinergic input but also on continuous nitrergic input, implying that fasting fundus tone is maintained by the balance of a cholinergic and nitrergic drive. Furthermore, fundus relaxation via 5-HT1 receptor activation is mediated through activation of a nitrergic pathway.

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