medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2021-23-92-99medalphabet-2235Research ArticleСОВРЕМЕННАЯ ПОЛИКЛИНИКАMODERN POLYCLINICЛекарственные средства, прием которых ассоциирован с развитием лекарственно-индуцированной гипонатриемии. Фокус на препараты, применяемые в неврологии и онкологииDrugs associated with drug-induced hyponatremiahttps://orcid.org/0000-0002-0401-1132ЛистратовА. И.ListratovA. I.

Александр Иванович Листратов, ординатор 2-го года кафедры терапии и полиморбидной патологии

Москва

Alexander I. Listratov, 2st year resident of Dept of Therapy and Polymorbid Pathology

Moskow

alexanderlistratoff@yandex.ruКомароваА. Г.KomarovaA. G.

Анна Григорьевна Комарова,  к. м. н., зам. главного врача

Москва

Anna G. Komarova, PhD Med, Deputy Chief Physician

Moskow

bellis-06@mail.ruhttps://orcid.org/0000-0002-3426-5467АлешковичЕ. В.AleshckovichE. V.

Елена Валерьевна Алешкович,  к. м. н., зав. кардиологическим отделением для больных с острым инфарктом миокарда

Москва

Elena V. Aleshckovich, PhD Med, Head of the Cardiology Department for patients with acute myocardial infarction No. 4

Moskow

elena.aleshckovitch@yandex.ruВеличкоМ. В.VelichckoM. V.

Мария Владимировна Величко, врач-невролог неврологического отделения

Сергиев Посад

Maria V. Velichcko, Neurological Department

Sergiev Posad

m-rykova@list.ruhttps://orcid.org/0000-0002-0795-8225ОстроумоваО. Д.OstroumovaO. D.

Ольга Дмитриевна Остроумова, проф., д. м. н., зав. кафедрой терапии и полиморбидной патологии, проф. кафедры клинической фармакологии и пропедевтики внутренних болезней

Москва

Olga D. Ostroumova, DM Sci, Professor, head of Dept of Therapy and Polymorbid Pathology Professor of Dept of Clinical Pharmacology and Propedeutics of Internal Diseases

Moskow

ostroumova.olga@mail.ruДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава РоссииРоссияRussian Medical Academy of Continuous Professional EducationRussian FederationГБУЗ «ГКБ им. С. П. Боткина» ДЗМРоссияBotkin City Clinical Hospital of the Moscow Department of HealthRussian FederationГБУЗ МО «Сергиево-Посадская районная больница»РоссияSergiev Posad District HospitalRussian FederationФГБОУ ДПО «Российская медицинская академия непрерывного последипломного образования» Минздрава России; ФГАОУ ВО ПМГМУ им. И. М. СеченоваРоссияRussian Medical Academy of Continuous Professional Education; I. M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation202129092021023Современная поликлиника (3)9299Copyright © Листратов А.И., Комарова А.Г., Алешкович Е.В., Величко М.В., Остроумова О.Д., 20212021Листратов А.И., Комарова А.Г., Алешкович Е.В., Величко М.В., Остроумова О.Д.Listratov A.I., Komarova A.G., Aleshckovich E.V., Velichcko M.V., Ostroumova O.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/2235

Гипонатриемия (ГН) является значимым нарушением волно-электролитного баланса в клинической практике. Одной из ведущих причин снижения уровня натрия являются лекарственные средства (АС). Антидепрессанты, противоэпилептические, антипсихотические, противоопухолевые препараты и опиоидные анальгетики являются наиболее частыми препаратами-индукторами гипонатриемии. Особое внимание следует уделять лицам с онкологическими заболеваниями, которые часто получают несколько препаратов-индукторов ГН. Факторами риска развития лекарственно-индуцированной (АИ) ГН при приеме большинства препаратов являются женский пол, снижение массы тела и пожилой возраст. У лиц, получающих терапию перечисленными препаратами, необходимо оценивать факторы риска снижения уровня натрия, клинические проявления со стороны нервной системы, определять уровень натрия в динамике. Особую осторожность необходимо проявлять при лечении пожилых пациентов, так как у них имеется сразу несколько факторов риска развития АИ ГН. Данные меры позволят профилактировать развитие ГН и ее тяжелых и иногда фатальных осложнений.

Hyponatremia (HN) is a significant disturbance of the water-electrolyte balance in clinical practice. Drugs are one of the leading causes of low sodium level. Antidepressants, antiepileptic, antipsychotic, antineoplastic drugs and opioid analgesics are the most common medications that induce hyponatremia. Special attention should be paid to people with cancer, who often receive several drugs that induce HN. Risk factors for the development of drug-induced (DI) HN when taking most medications are female sex, weight loss, and old age. In persons receiving therapy with the listed drugs, it is necessary to assess the risk factors for a decrease in the sodium level, clinical manifestations from the nervous system, and to determine the sodium level in dynamics. Special care must be taken when treating elderly patients, since they have several risk factors for the development of DI HN. These measures will help prevent the development of HN and its severe and sometimes fatal complications.

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The authors declare that there are no conflicts of interest present.