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Increased Risk of Drug-Induced Hyponatremia during High Temperatures
National Board Forens Med, Department Forens Genet and Forens Toxicol, S-58758 Linkoping, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.ORCID iD: 0000-0002-5371-3827
Umeå University, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
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2017 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 7, article id 827Article in journal (Refereed) Published
Abstract [en]

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 degrees C. The change in sodium per 1 degrees 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.

Place, publisher, year, edition, pages
MDPI AG , 2017. Vol. 14, no 7, article id 827
Keywords [en]
average daily temperature; hyponatremia; adverse drug reaction
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:liu:diva-140807DOI: 10.3390/ijerph14070827ISI: 000407370700159PubMedID: 28737683OAI: oai:DiVA.org:liu-140807DiVA, id: diva2:1140812
Note

Funding Agencies|County Council of Ostergotland [LIO-448321]; Umea Centre for Global Health Research at Umea University; FORTE; Swedish Council for Working Life and Social Research [2006 1512]

Available from: 2017-09-13 Created: 2017-09-13 Last updated: 2018-02-22

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Ekman, Bertil

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