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Increased Risk of Drug-Induced Hyponatremia during High Temperatures

机译：高温导致药物性低钠血症的风险增加

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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
机译：目的：调查瑞典的室外温度与向医疗产品管理局（MPA）报告药物引起的低钠血症之间的关系。方法：确定2010年1月1日至2013年10月31日向MPA报告的所有可疑药物引起的低钠血症的个人不良药物反应（ADR）和随机对照。报告中的ADR已被评估为至少与可疑药物有关。提取了有关给药药物，起效日期，因果关系评估，钠水平和报告地理来源的信息。病例交叉设计用于确定个体暴露水平与药物引起的低钠血症之间的关系，而线性回归则用于研究其与血液钠浓度的关系。从最近的观测站到所报告病例的温度暴露数据。结果：在研究期间，发现了280例低钠血症的报告。据报道，在温暖的季节，有更多的药物性低钠血症病例，6月达到峰值，而其他ADR则呈现相反的年度模式。分布滞后非线性模型表明，在温暖季节，随温度升高，比值比（OR）升高，且比值比最高，受热后延迟1-5天。在每日平均温度为20°C时，滞后时间为1至3天的累积OR估计为2.21。温度每升高1摄氏度，钠的变化估计约为0.37 mmol / L（95％CI：0.02或0.72）。结论：温暖的天气似乎增加了药物性低钠血症的风险

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