HIGH SODIUM-HYPERNATREMIA-II-CONTINUED

HYPERNATREMIA-DRUG ABUSES AND OTHER CAUSES

Hypernatremia occurs due to the improper use of certain drugs such as osmotic diuretics.

Osmotic diuretics are drugs producing diuresis to excrete more urea nitrogen and glucose and competitively inhibit the excretion of sodium and water. They increase the blood and extracellular water and sodium level and thereby produce hypernatremia.
Other medications such as anabolic steroids(Durabolin), ACTH (Adreno Cortico Tropic Hormone) and female sex hormones also produce hypernatremia 

The best examples for osmotic diuretics are mannitol and isosorbide.
The concept of osmotic diuretics is to produce high osmotic pressure between blood capillaries and kidney tubules and thereby suck more solvent towards the tubules for excretion. But in this case urea, glucose and blood urea nitrogen are the solutes that suck the water towards the tubules and thereby raise the mineral content of the blood including sodium.
Glucocorticoids on the contrary inhibit the excretion of the solvent along with sodium by the kidneys and thereby raise the blood volume and sodium.

Those who have diabetes mellitus, kidney failure with high blood urea nitrogen(BUN) should avoid the use of mannitol and isosorbide in their B.P.drugs profile.

Mannitol is usually recommended by the eye specialist to reduce intraocular pressure(IOP) in the treatment of glaucoma. Similarly both mannitol and isosorbide are drugs of choice to reduce intracranial pressure for B.P. patients. Before starting with this drug you must submit your full medical history including diabetes and kidney problems.
Other medications such as sodium chloride (table salt), and sodium bicarbonate (Baking salt) also can raise your blood and extracellular sodium level if used in high quantity.
Chronic use of corticosteroids such as aldosterone(Aldomet) can raise blood sodium levels by increasing potassium loss with the exchange of sodium by the distal tubule of the kidneys.
Glucocorticoids such as hydrocortisone and cortisol also produce hypernatremia by suppressing the secretion of ADH by the brain.
Male and female sex hormones can also produce hypernatremia

Foods with high sodium contents:-

Foods such as salty foods and beverages such as Soup, and vegetable juice
Instant puddings,
Shrimps
Cottage cheese
Salads
Pizzas.
These foods should be avoided if you are positively diagnosed with hypernatremia.

Symptoms:-

1. The main symptoms are lethargy and confusion verily in the case of Diabetes Insipidus.

2. Craving for salt is one of the symptoms that you have high sodium in your body.

3.Extreme thirsty which indicates you have high osmotic pressure between your lower intracellular fluid volume and higher extracellular fluid volume.

4.Frequent Urinations

5.Swellings

6.Episodes of Headaches

7. Hesitate to take food in spite of hungry.

Diagnosis:-

Blood and urine tests.

Treatments:-

For acute cases slow intravenous drip of 5% glucose.

For chronic cases intravenous drip of half-normal saline (0.045%)