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Hyponatremia after initiation and rechallenge with trimethoprim-sulfamethoxazole in an older adult.

Abstract The purpose of this study is to describe a case report of a patient experiencing hyponatremia from trimethoprim-sulfamethoxazole (TMP-SMX) upon initial use and subsequent rechallenge.
PMID
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Authors

Mayor MeshTerms
Keywords

aged

drug-related side effects and adverse reactions

hyponatremia

trimethoprim–sulfamethoxazole combination

Journal Title clinical interventions in aging
Publication Year Start




PMID- 26170649
OWN - NLM
STAT- MEDLINE
DCOM- 20160218
LR  - 20150719
IS  - 1178-1998 (Electronic)
IS  - 1176-9092 (Linking)
VI  - 10
DP  - 2015
TI  - Hyponatremia after initiation and rechallenge with trimethoprim-sulfamethoxazole 
      in an older adult.
PG  - 1091-6
LID - 10.2147/CIA.S82823 [doi]
AB  - PURPOSE: The purpose of this study is to describe a case report of a patient
      experiencing hyponatremia from trimethoprim-sulfamethoxazole (TMP-SMX) upon
      initial use and subsequent rechallenge. SUMMARY: An 82-year-old woman presented
      to the emergency department with altered mental status thought to be due to
      complicated cystitis and was treated with TMP-SMX 160 mg/800 mg orally twice
      daily for 7 days. Her basic metabolic panel prior to initiation of TMP-SMX was
      within normal limits, with the exception of her serum sodium of 132 mmol/L (range
      133-145 mmol/L). The day after completing her 7-day course of TMP-SMX therapy the
      patient was evaluated by her primary care provider and another basic metabolic
      panel revealed a reduction in the serum sodium to 121 mmol/L. The patient's serum
      sodium concentrations increased to baseline 7 days after completion of the
      TMP-SMX therapy, and remained normal until she was treated in the emergency
      department several months later for another presumed urinary tract infection. She
      was again started on TMP-SMX therapy empirically, and within several days her
      serum sodium concentrations decreased from 138 mmol/L to a low of 129 mmol/L. The
      TMP-SMX therapy was discontinued upon negative urine culture results and her
      serum sodium increased to 134 mmol/L upon discharge. Based upon the Naranjo
      probability scale score of 9, TMP-SMX was the probable cause of the patient's
      hyponatremia. CONCLUSION: Our patient developed hyponatremia from TMP-SMX therapy
      upon initial use and rechallenge. Although hyponatremia appears to be rare with
      TMP-SMX therapy, providers should be aware of this potentially life-threatening
      adverse event.
FAU - Huntsberry, Ashley M
AU  - Huntsberry AM
AD  - University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences,
      Aurora, CO, USA.
FAU - Linnebur, Sunny A
AU  - Linnebur SA
AD  - University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences,
      Aurora, CO, USA.
FAU - Vejar, Maria
AU  - Vejar M
AD  - Division of Geriatrics, Department of Internal Medicine, University of Colorado
      School of Medicine, Aurora, CO, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20150701
PL  - New Zealand
TA  - Clin Interv Aging
JT  - Clinical interventions in aging
JID - 101273480
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
SB  - IM
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Hyponatremia/*chemically induced
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/*adverse effects/therapeutic use
MH  - Urinary Tract Infections/*drug therapy
PMC - PMC4494188
OID - NLM: PMC4494188
OTO - NOTNLM
OT  - aged
OT  - drug-related side effects and adverse reactions
OT  - hyponatremia
OT  - trimethoprim-sulfamethoxazole combination
EDAT- 2015/07/15 06:00
MHDA- 2016/02/19 06:00
CRDT- 2015/07/15 06:00
PHST- 2015/07/15 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2016/02/19 06:00 [medline]
AID - 10.2147/CIA.S82823 [doi]
AID - cia-10-1091 [pii]
PST - epublish
SO  - Clin Interv Aging. 2015 Jul 1;10:1091-6. doi: 10.2147/CIA.S82823. eCollection
      2015.