Reactions 1680, p308 - 2 Dec 2017 Hyponatraemia: case report A 69-year-old man developed hyponatraemia during treatment with sildenafil [Viagra; route, indication and time to reaction onset not stated]. The man, who had no history of disease, had been receiving one tablet of sildenafil 50mg everyday for several months. One day, after taking sildenafil, he suddenly experienced cramps for some time and lost conciousness at home, and was hospitalised. In spite of being haemodynamically stable, he was confused and losing conciousness on and off (Glasgow Coma Scale [GCS] score: 9 (E2V2M5)). Brain CT scan and MRI revealed mild atrophy. Electroencephalography demonstrated no typical spike-and-wave pattern. Serum sodium level and serum osmolality were 113 mEq/L and 237 mOsm/kg, respectively. Antidiuretic hormone and cortisol levels were 2.2 pg/mL and 18.4 µg/dL, respectively. According to the criteria of Bartter and Schwartz, suspected mechanism of this severe hyponatraemia might have been by the syndrome of inappropriate secretion of antidiuretic hormone. The man received treatment with sodium chloride [saline]. As a result, after 4 days of the hospitalisation, he recovered from hyponatraemia with serum sodium level returning to normal. He was responsive with a GCS of 15 (E4V5M6). He was discharged after 8 days of the the hospitalisation, and hyponatraemia was suspected to be sildenafil-induced. Author comment: "First, we must consider the possibility of severe hyponatraemia occurring in patients taking sildenafil." "Sildenafil is suspected to have caused the severe hyponaetremia in this case" Taguchi H, et al. Severe hyponatremia associated with sildenafil (Viagra). Acute Medicine and Surgery 2: 223, No. 3, Jul 2015. Available from: URL: http:// doi.org/10.1002/ams2.91 - Japan 803284847 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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