Sodium Deficiency (Hyponatremia): Medical History

Medical history (history of illness) represents an important component in the diagnosis of hyponatremia (sodium deficiency).

Family history

• Do family members (e.g., parents/grandparents) have metabolic diseases?

Social history

• What is your profession?

Current medical history/systemic history (somatic and psychological complaints).

• Do you suffer from nausea?
• Have you been vomiting?
• Do you have a headache?
• Is your daily urine volume decreased (< 500 ml)* ?
• Do you have water retention in the legs?
• Do you suffer from insomnia* ?

Vegetative anamnesis incl. nutritional anamnesis.

• Do you drink enough? How much have you drunk today?
• Do you consciously avoid the intake of table salt?
• Do you drink alcohol? If so, what drink(s) and how many glasses per day?
• Do you use drugs? If yes, what drugs and how often per day or per week?

Self history incl. medication history.

• Pre-existing conditions (kidney disease; heart failure (cardiac insufficiency); pancreatic disease; liver cirrhosis (irreversible (non-reversible) damage to the liver associated with marked remodeling of liver tissue); kidney disease; metabolic disease).
• Surgery (transurethral resection of the prostate (TURP); removal of the prostate through the urethra).

Medication history

• ACE inhibitor4
• Analgesics
  • Non-steroidal anti-inflammatory drugs (NSAIDs)3, also called non-steroidal anti-inflammatory drugs (NSAPs) or NSAIDs.
• Antidepressants
  • Group of noradrenergic and specific serotonergic antidepressants (NaSSA) – mirtazapine [moderate risk].
  • Selective serotonin–norepinephrine reuptake inhibitor (SSNRI) – venlafaxine [high risk].
  • Selective serotonin reuptake inhibitors1 (SSRI = Selective Serotonin Reuptake Inhibitor) – citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine, sertarline [high risk].
  • Tricyclic antidepressants (TCAs) – amitriptyline4 [moderate risk]
• Antimalarials (atovaquone).
• Anticonvulsants (carbamazepine1, gabapentin, lamotrigine, topiramate).
• Antipsychotics (neuroleptics) – haloperidol4
• Diuretics
  • Thiazide diuretics (hydrochlorothiazide (HCT), benzthiazide, clopamide, chlortalidone (CTDN), chlorothiazide, hydroflumethiazide, indapamide, methyclothiazide, metolazone, polythiazide and trichloromethiazide, xipamide).
• Drugs
  • Ecstasy4
  • Opiates1
• Fibrates (Clofibrate
• Filling/swelling agents (psyllium, flaxseed) [for prolonged use].
• Hormones
  • Desmopressin2
  • Oxytocin2
  • Vasopressin2
• Infusions
  • Physiological hypotonic solutions
  • Glucose-containing liquids
• Sulfonylurea (glibenclamide glibenclamide, glibornuride, gliclazide, glipizide, gliquidone, glisoxepide, glycodiazine (Redul) third generation sulfonylureas: glimepiride (Amaryl) )
• Cytostatic drugs3 (cyclophosphamide, platinum compounds, vinca alkaloids).

1 Drugs that stimulate the release of antidiuretic hormone (ADH) 2 Drugs that exogenously supply ADH 3 Drugs that may potentiate the action of ADH 4 Drugs that may cause hyponatremia of unclear etiology.

* If this question has been answered with “Yes”, an immediate visit to the physician is required! (Data without guarantee)