Лекарственные средства, прием которых ассоциирован с развитием лекарственно-индуцированной гипонатриемии. Антигипертензивные препараты и ингибиторы протонной помпы

Гипонатриемия (ГН) является одним из ведущих водно-электролитных нарушений в повседневной врачебной практике. Снижение уровня натрия опасно развитием различных осложнений. Поэтому для эффективной профилактики ГН и ее осложнений особое внимание следует уделять модифицируемым факторам риска. Одной из важных причин, приводящих к ГН, являются лекарственные средства (ЛС). Наиболее часто ГН развивается на фоне терапии тиазидными и тиазидоподобными диуретиками. Факторами риска ее развития являются тиазид-индуцированная ГН в анамнезе, пожилой возраст, женский пол, низкая масса тела и гипокалиемия. Проблема тиазид-индуцированной ГН требует дальнейшего изучения патогенетических механизмов и определения генетических факторов, лежащих в ее основе. Необходимо также помнить о возможности развития ГН на фоне таких препаратов, широко применяемых в терапевтической практике, как блокаторы ренин-ангиотензин-альдостероновой системы (РААС) и ингибиторы протонной помпы (ИПП). У пациентов, получающих терапию перечисленными препаратами, необходимо уделять внимание возможным клиническим проявлениям ГН и определять уровень натрия в динамике, что позволит эффективно профилактировать развитие данного нарушения.

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