Principal causes and the underlying mechanisms of drug-induced hypernatraemia


A. Water loss
1. Renal losses
(i) Acquired nephrogenic diabetes insipidus
  Drug-induced hypokalaemia: diuretics, cisplatin, aminoglycosides,
  amphotericin B, penicillin derivatives
  Drug-induced hypercalcaemia: lithium, vitamin A or D excess
  Other drugs: lithium, demeclocycline, amphotericin B, foscarnet,
   colchicine, vinblastine, vasopressin V2-receptor antagonists
(ii) Central diabetes insipidus
  Lithium, phenytoin, ethanol

(iii) Other causes
  Loop diuretics
  Osmotic diuresis
  Mannitol administration
  Nutritional supplementation
  Urea
  Agents that cause increased production of urea: corticosteroids,
   high-protein supplements

2. Gastrointestinal losses
  Osmotic cathartic agents: lactulose, sorbitol

B. Hypertonic sodium gain
  Hypertonic sodium bicarbonate infusion
  Hypertonic sodium chloride infusion
  Hypertonic feeding preparation
  Sodium chloride-rich emetics
  Hypertonic saline enemas
  Intrauterine injection of hypertonic saline
  Hypertonic saline irrigation of intra-abdominal hydatid cysts
  Hypertonic dialysis
  N-acetylcysteine

 http://ckj.oxfordjournals.org/content/2/5/339/T1.expansion.html

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