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Hyponatremia

Also called water intoxication, hyponatremia is a condition when the blood sodium level drops down drastically or drops to a lower than normal level. Sodium is an electrolyte that helps regulate the water around the cells. Hyponatremia is a condition wherein the sodium in the body gets diluted due to excessive water intake or some medical condition. When this particular condition sets in, the water level in the body rises and the cells begin to swell. The level of water accumulated in the body is higher than that can be excreted. This swelling causes various health problems that may range from mild to severe.

Normal level of sodium in the body is between 135 and 145 milliequivalents per liter of sodium. When sodium level falls below 135mEq/L, hyponatremia occurs. Blood tests and urine tests help diagnose the condition. Treatment includes restricted water intake, drugs, medications, etc.

Hypovolemic hyponatremia: Too little water and sodium in the body, this condition occurs due to excessive sweating while exercising.

Euvolemic hyponatremia: Water level is too high, this condition occurs due to certain medications or chronic health conditions.

Hypervolemic hyponatremia: Body has too much water, occurs as a result of kidney failure, liver failure or heart failure.

Common causes include:



Hyponatremia symptoms

Common symptoms reported include nausea, headache, confusion, muscle cramps, seizures and loss of energy.

Antacids

One of the common stomach disorders encountered is gastro esophageal reflux also known as heartburn. The stomach contains hydrochloric acid which helps in digestion of the food and subsequently killing ingested microorganisms. The acidity of the gastric HCl is 2M and any increase in the acidity leads to reflux, in which the gastric HCl travels through the cardiac sphincter muscle to the esophagus causing burning sensation and discomfort. Antacids are common choice of drugs which are administered in these conditions as they reduce the acid reflux and peptic ulcer.

Antacids act locally in the stomach region to neutralize the effect of the gastric HCl in order to prevent the onset of peptic ulcer. Most antacids are not absorbed and they are easily excreted in the stool. The predominant forms of chemicals used in the preparation of antacids include sodium bicarbonate, potassium bicarbonate, aluminum hydroxide, aluminum carbonate, magnesium carbonate, magnesium oxide and calcium carbonate. The natural forms of antacids include ginger, bananas, aloe vera, chamomile (used along with tea), carrots and turmeric. The action of antacids on the stomach is carried out throughout the wall to prevent ulcer formation.


Types of antacids

Antacids are recommended depending upon the intensity of the gastric disorder. In normal or mild conditions of acidity, non systemic antacids are recommended as they do not cause much damage. Prolonged administration of systemic antacids may lead to a condition called alkalosis in which the PH of the blood is raised leading to renal failure. Some of the common types of antacids used in the treatment of reflux and peptic ulcers are:

Sodium bicarbonate: It is recommended by many doctors to treat acid reflux and also reduce the acidity of urine and blood. Antacids which contain sodium bicarbonate also contain baking soda and hence it is not recommended for patients having congestive heart failure, hypertension, kidney disorders and gastrointestinal bleeding. Antacids containing sodium bicarbonate should be taken only after meals on a partially full stomach. The side effects include nausea, flatulence, weakness, increased thirst, black stools and irritability.

Aluminum hydroxide: Aluminum hydroxide is widely used as a non-systemic antacid and in most cases is available without prescription. The side effects of aluminum hydroxide include constipation and abdominal discomfort. In order to avoid constipation and abdominal stress, aluminum hydroxide is given in combination with magnesium hydroxide which has laxative properties along with antacid effects The combination of two such compatible antacids helps in sustained action in relieving peptic ulcers and protecting the wall of the stomach.

Calcium Carbonate: These antacids are mainly used in the treatment of indigestion, flatulence along with acidity and more commonly used as it is less expensive than other types of antacids. They are mostly recommended for children below the age of 12. In patients who have a previous history of osteoporosis or any other type of calcium deficiencies, the intake of calcium carbonate in case of acidity also helps in balancing the calcium requirement. If patients have a history of renal calculi or any other allergic reaction, calcium carbonate antacids should be avoided. The major side effect of this antacid is that it interacts with cardiac drugs. Calcium carbonate based antacids usually disintegrate and dissolute in forty minutes.

Drug side effects

Antacids react with many medications; digoxin, isoniazid, quinidine, pseudoephedrine and tetracycline. The potency and absorption of the drug reduces when the antacids interact with the corresponding drugs.


Aldosterone test

Aldosterone test maesures the level of aldosterone hormone in the blood. Aldosterone performs the task of maintaining optimal levels of sodium and potassium in the blood by maintaining water balance and blood volume. Elevated levels of aldosterone are indicative of aldosteronism or hyperaldosteronism. The presence of a tumor may bring about high levels of aldosterone. Low levels of aldosterone may suggest diabetes or Addison's disease. Pregnant women may notice high values of aldosterone in the blood.

Medications such as corticosteroids, diuretics, female hormones and hypertension drugs can affect the results of aldosterone test. Even the body posture can affect aldosterone levels in the blood. The amount of salt consumed can cause changes in blood aldosterone levels. Aldosterone test is conducted to study any possible overactivity of adrenal glands. Aldosterone test is conducted on a blood sample or 24 hour urine sample. Normal aldosterone range for urine is 2-80 mg/24 hr. Typical blood aldosterone range is 3-10 ng/dL when the patient is in supine position and 5 - 20 ng/dL when sitting upright.

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Bibliography / Reference

Collection of Pages - Last revised Date: November 15, 2019