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Increased Risk of Drug-Induced Hyponatremia during High Temperatures

Purpose: To investigate the relationship between outdoor temperature in Sweden and the reporting of drug-induced hyponatremia to the Medical Products Agency (MPA). Methods: All individual adverse drug reactions (ADR) reported to MPA from 1 January 2010 to 31 October 2013 of suspected drug-induced hy...

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Autores principales: Jönsson, Anna K., Lövborg, Henrik, Lohr, Wolfgang, Ekman, Bertil, Rocklöv, Joacim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551265/
https://www.ncbi.nlm.nih.gov/pubmed/28737683
http://dx.doi.org/10.3390/ijerph14070827
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author Jönsson, Anna K.
Lövborg, Henrik
Lohr, Wolfgang
Ekman, Bertil
Rocklöv, Joacim
author_facet Jönsson, Anna K.
Lövborg, Henrik
Lohr, Wolfgang
Ekman, Bertil
Rocklöv, Joacim
author_sort Jönsson, Anna K.
collection PubMed
description Purpose: To investigate the relationship between outdoor temperature in Sweden and the reporting of drug-induced hyponatremia to the Medical Products Agency (MPA). Methods: All individual adverse drug reactions (ADR) reported to MPA from 1 January 2010 to 31 October 2013 of suspected drug-induced hyponatremia and random controls were identified. Reports where the ADR had been assessed as having at least a possible relation to the suspected drug were included. Information on administered drugs, onset date, causality assessment, sodium levels, and the geographical origin of the reports was extracted. A case-crossover design was used to ascertain the association between heat exposure and drug-induced hyponatremia at the individual level, while linear regression was used to study its relationship to sodium concentration in blood. Temperature exposure data were obtained from the nearest observation station to the reported cases. Results: During the study period, 280 reports of hyponatremia were identified. More cases of drug-induced hyponatremia were reported in the warmer season, with a peak in June, while other ADRs showed an opposite annual pattern. The distributed lag non-linear model indicated an increasing odds ratio (OR) with increasing temperature in the warm season with a highest odds ratio, with delays of 1–5 days after heat exposure. A cumulative OR for a lag time of 1 to 3 days was estimated at 2.21 at an average daily temperature of 20 °C. The change in sodium per 1 °C increase in temperature was estimated to be −0.37 mmol/L (95% CI: −0.02, −0.72). Conclusions: Warm weather appears to increase the risk of drug-induced hyponatremia.
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spelling pubmed-55512652017-08-11 Increased Risk of Drug-Induced Hyponatremia during High Temperatures Jönsson, Anna K. Lövborg, Henrik Lohr, Wolfgang Ekman, Bertil Rocklöv, Joacim Int J Environ Res Public Health Article Purpose: To investigate the relationship between outdoor temperature in Sweden and the reporting of drug-induced hyponatremia to the Medical Products Agency (MPA). Methods: All individual adverse drug reactions (ADR) reported to MPA from 1 January 2010 to 31 October 2013 of suspected drug-induced hyponatremia and random controls were identified. Reports where the ADR had been assessed as having at least a possible relation to the suspected drug were included. Information on administered drugs, onset date, causality assessment, sodium levels, and the geographical origin of the reports was extracted. A case-crossover design was used to ascertain the association between heat exposure and drug-induced hyponatremia at the individual level, while linear regression was used to study its relationship to sodium concentration in blood. Temperature exposure data were obtained from the nearest observation station to the reported cases. Results: During the study period, 280 reports of hyponatremia were identified. More cases of drug-induced hyponatremia were reported in the warmer season, with a peak in June, while other ADRs showed an opposite annual pattern. The distributed lag non-linear model indicated an increasing odds ratio (OR) with increasing temperature in the warm season with a highest odds ratio, with delays of 1–5 days after heat exposure. A cumulative OR for a lag time of 1 to 3 days was estimated at 2.21 at an average daily temperature of 20 °C. The change in sodium per 1 °C increase in temperature was estimated to be −0.37 mmol/L (95% CI: −0.02, −0.72). Conclusions: Warm weather appears to increase the risk of drug-induced hyponatremia. MDPI 2017-07-22 2017-07 /pmc/articles/PMC5551265/ /pubmed/28737683 http://dx.doi.org/10.3390/ijerph14070827 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jönsson, Anna K.
Lövborg, Henrik
Lohr, Wolfgang
Ekman, Bertil
Rocklöv, Joacim
Increased Risk of Drug-Induced Hyponatremia during High Temperatures
title Increased Risk of Drug-Induced Hyponatremia during High Temperatures
title_full Increased Risk of Drug-Induced Hyponatremia during High Temperatures
title_fullStr Increased Risk of Drug-Induced Hyponatremia during High Temperatures
title_full_unstemmed Increased Risk of Drug-Induced Hyponatremia during High Temperatures
title_short Increased Risk of Drug-Induced Hyponatremia during High Temperatures
title_sort increased risk of drug-induced hyponatremia during high temperatures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551265/
https://www.ncbi.nlm.nih.gov/pubmed/28737683
http://dx.doi.org/10.3390/ijerph14070827
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