HYPONATREMIA ASSOCIATED WITH NONSTEROIDAL ANTIINFLAMMATORY DRUGS

The effects of renal prostaglandins on medullary blood flow, active ch loride transport, and antidiuretic hormone are important in urine dilu tion. It is surprising, therefore, that drugs that inhibit prostagland in synthesis rarely cause hyponatremia. A patient in whom hyponatremia developed during ibuprofen administration is described and other repo rted cases of this association in adults are reviewed. The previous ca se reports fall into two well defined groups: first, neonates treated with indomethacin for patent ductus, and second, adults, often elderly , who usually have other diseases that impair urinary dilution. Althou gh hyponatremia is a rare consequence of therapy with prostaglandin in hibitors, certain individuals are at increased risk and should be moni tored for this side effect.