pituitrin and Water-Intoxication

Vasopressin has gained wide support as an adjunct vasopressor in patients with septic shock. This agent exerts its vasoconstriction effects through smooth muscle V1 receptors and also has antidiuretic activity via renal V2 receptors. This interaction with the renal V2 receptors results in the integration of aquaporin 2 channels in the apical membrane of the renal collecting duct leading to free water reabsorption. Thus, water intoxication with subsequent hyponatremia, although rare, is a potentially serious side effect of exogenous vasopressin administration. We present 2 patients who developed hyponatremia within hours of initiation of vasopressin infusion. Extensive diuresis followed its discontinuation with subsequent normalization of serum sodium. One of the patients required the use of hypertonic saline for more rapid normalization of serum sodium due to concerns for potential seizure activity. A review of the literature relevant to the incidence of vasopressin-induced hyponatremia is provided as well as discussion on additional factors relevant to septic shock that should be considered when determining the relative risk of hyponatremia in patients receiving vasopressin.

Topics: Adrenal Cortex Hormones; Diuresis; Female; Humans; Hyponatremia; Male; Receptors, Vasopressin; Shock, Septic; Sodium; Vasoconstrictor Agents; Vasopressins; Water Intoxication; Young Adult

Disorders of water homeostasis are common in psychiatric patients and include compulsive water drinking, the syndrome of inappropriate antidiuretic hormone secretion (SIADH), and the syndrome of self-induced water intoxication (SIWI). Although water intoxication was recognized nearly 70 years ago, the physiological basis of these disorders of water metabolism still remains elusive. This review will provide a historical overview, critique current studies on compulsive water drinking and SIWI, discuss possible etiologies, and present current approaches to treatment of these disorders. Because of the complexity of the subject, a review of normal water homeostasis and the SIADH will be included.

Topics: Drinking; Humans; Hyponatremia; Inappropriate ADH Syndrome; Mental Disorders; Psychotropic Drugs; Thirst; Vasopressins; Water Intoxication

A 31-year-old woman with untreated chronic schizophrenia developed extreme polydipsia which rapidly led to coma and death due to cerebral edema. Hyponatremia (120 mEq/liter) and serum hypo-osmolality (260 mOsm/kg) were associated with marked polyuria (up to 1850 ml/hour) and appropriately low urinary osmolality (90 mOsm/kg) which responded to treatment. This case and few qualifying previous reports which are reviewed support the possibility that pure self-induced water intoxication with no major contribution of inadequate release of antidiuretic hormone may occur, and that extreme polydipsia can sometimes overwhelm normal renal diluting capacity in psychotic patients.

Topics: Adult; Drinking; Female; Humans; Osmolar Concentration; Schizophrenia; Vasopressins; Water Intoxication

A male quadriplegic (C6--complete) with persistent chronic hyponatremia (serum sodium values ranging consistently from 117-132 mmol/L) developed acute hyponatremia with a serum sodium concentration of 98 mmol/L. This extreme hyponatremia related, in part, to a reversible defect in the excretion of a water load, while on a low (46 mmol/day) sodium diet. Subsequent ingestion of a normal sodium diet (150 mmol/day), with or without 0.1 mg of fludrocortisone (Florinef), reestablished his ability to excrete a water load normally. The etiology of this patient's hyponatremia is discussed as well as the unique concordance of factors which make hyponatremia a common occurrence among spinal-cord injured patients.

Topics: Acute Disease; Diet, Sodium-Restricted; Fludrocortisone; Humans; Hyponatremia; Male; Middle Aged; Osmolar Concentration; Sodium, Dietary; Spinal Cord Injuries; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Brain Diseases; Diabetes Insipidus; Electrolytes; Humans; Hypernatremia; Hyponatremia; Postoperative Complications; Vasopressins; Water; Water Intoxication; Water-Electrolyte Imbalance

SIADH consists of hyponatremia and hyposmolality, continued urinary loss of sodium, excretion of an inappropriately concentrated urine, and absence of dehydration, usually in the presence of normal renal and adrenal function. The retention of excess water caused by the inappropriate secretion of antidiuretic hormone is central to the development of the syndrome. In pediatrics, SIADH is most commonly seen in patients with meningitis or postoperatively. Fluid restriction is vital in such patients to prevent the development of symptomatic SIADH. Fluid restriction alone will also result in the correction of serum electrolyte composition in patients with SIADH. Hypertonic saline should be used only in severely symptomatic patients.

Topics: Adult; Aldosterone; Blood Volume; Child; Diuresis; Drinking; Ethanol; Humans; Hyponatremia; Kidney Concentrating Ability; Kidney Tubules, Distal; Kidney Tubules, Proximal; Lithium; Osmolar Concentration; Saline Solution, Hypertonic; Sodium; Syndrome; Vasopressins; Water Intoxication; Water-Electrolyte Imbalance

Topics: Adult; Blood Proteins; Diabetic Coma; Diuresis; Female; Humans; Hypertonic Solutions; Hyponatremia; Kidney Diseases; Lipids; Male; Mannitol; Middle Aged; Osmolar Concentration; Peritoneal Dialysis; Renal Dialysis; Sodium Chloride; Vasopressins; Water Intoxication

Topics: Acetaminophen; Amitriptyline; Animals; Anura; Body Fluids; Carbamazepine; Chlorpropamide; Clofibrate; Cyclophosphamide; Diabetes Insipidus; Diabetes Mellitus; Diazoxide; Drug-Related Side Effects and Adverse Reactions; Humans; Hypoglycemic Agents; Hyponatremia; Kidney; Rats; Sodium; Sulfonylurea Compounds; Tolbutamide; Urinary Bladder; Vasopressins; Vincristine; Water Intoxication; Water-Electrolyte Balance

Topics: Carcinoma, Small Cell; Central Nervous System Diseases; Endocrine System Diseases; Hormones, Ectopic; Humans; Hyponatremia; Kidney; Lung Diseases; Lung Neoplasms; Osmolar Concentration; Paraneoplastic Endocrine Syndromes; Syndrome; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Adrenal Glands; Aldosterone; Feedback; Glomerular Filtration Rate; Humans; Hyponatremia; Kidney; Kidney Diseases; Kidney Neoplasms; Mixed Function Oxygenases; Natriuresis; Sodium; Vasopressins; Water Intoxication

Topics: Chlorides; Humans; Hydrogen-Ion Concentration; Hypernatremia; Hyponatremia; Infusions, Parenteral; Sodium; Vasopressins; Water Intoxication

Topics: Adrenal Gland Diseases; Central Nervous System Diseases; Diagnosis, Differential; Humans; Hyponatremia; Hypothalamus; Vasopressins; Water Intoxication

Topics: Adrenal Insufficiency; Diuresis; Glucocorticoids; Humans; Hypothyroidism; Kidney; Kidney Failure, Chronic; Osmolar Concentration; Urination Disorders; Vasopressins; Water; Water Intoxication

Topics: Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Cold Temperature; Dental Caries; Etodolac; Female; Humans; Hyponatremia; Neurophysins; Protein Precursors; Renal Elimination; Seizures; Sodium; Toothache; Vasopressins; Water; Water Intoxication; Water-Electrolyte Balance

Topics: Diagnosis, Differential; Humans; Hyponatremia; Inappropriate ADH Syndrome; Male; Middle Aged; Polydipsia, Psychogenic; Rhabdomyolysis; Vasopressins; Water Intoxication

Schizophrenia, many believe, reflects an enhanced vulnerability to psychological stress. Controlled exposure to stressors, however, has produced inconclusive results, particularly with regards to neurohormones. Some of the variability may be attributable to the nature and psychological significance of the stimulus and failure to control physiologic confounds. In addition, it is possible that the heterogeneity of schizophrenia is an important factor. In a carefully designed study and in a controlled setting, we measured the neuroendocrine response of eight polydipsic hyponatremic (PHS), seven polydipsic normonatremic (PNS), and nine nonpolydipsic normonatremic (NNS) (ie normal water balance) schizophrenic in-patients as well as 12 healthy controls (HC) to two different stressors: one of which appears to influence neuroendocrine secretion through its psychological (cold pressor) and the other (upright posture) through its systemic actions. Subjects in the three psychiatric groups were stabilized and acclimated to the research setting, and all received saline to normalize plasma osmolality. Following the cold pressor, plasma adrenocorticotropin and cortisol levels showed a more prolonged rise in PHS patients relative to PNS patients. NNS patients, in contrast, exhibited blunted responses relative to both of the polydipsic groups and the HC. Peak vasopressin responses were also greater in PHS and blunted in NNS patients. Responses to the postural stimulus were similar across patient groups. These findings provide a mechanism for life threatening water intoxication in schizophrenia; help to reconcile conflicting findings of stress responsiveness in schizophrenia; and potentially identify a discrete patient subset with enhanced vulnerability to psychological stress.

Topics: Adult; Cold Temperature; Drinking; Endocrine System Diseases; Female; Humans; Hyponatremia; Hypothalamo-Hypophyseal System; Male; Middle Aged; Neurosecretory Systems; Schizophrenia; Stress, Psychological; Thirst; Vasopressins; Water Intoxication; Water-Electrolyte Imbalance

A 66-year-old woman was admitted to our hospital because of vomiting and appetite loss. For the 2 days prior to admission, she had a cold, which had developed into acute viral bronchitis on admission. Because laboratory data on admission showed hyponatremia, intravenous infusion of Ringer's lactate solution was started. However, generalized seizures appeared, and she developed a coma on the day of admission. Her plasma antidiuretic hormone (ADH) level was high in the context of a low serum osmolality on the second hospital day. The infusion rate was increased, and the patient's consciousness level returned to normal. However, her normalized serum Na level declined again as she drank much water to reduce throat discomfort. As the throat discomfort caused by the throat inflammation improved with azulene gargling, her water intake was reduced, and the serum Na concentration returned to normal. Thus, polydipsia caused by a throat inflammation partially contributed to hyponatremia in this patient. We note that increased ADH secretion has been reported in adults with acute respiratory infection. Therefore, we concluded that polydipsia caused by the throat inflammation, plus increased ADH secretion, resulted in hyponatremia in this patient. We should pay attention to the behavior of drinking extra fluid in patients with acute respiratory infections.

Topics: Aged; Bronchitis; Drinking Behavior; Female; Humans; Hyponatremia; Pharyngitis; Seizures; Vasopressins; Water Intoxication

To study hormonal factors that may account for the dissociation between beverage-induced plasma sodium p[Na+] and osmotic p[Osm] concentrations that appear to refute the high theoretical correlation between p[Na+] and p[Osm].. Ten men (24 +/- SD 3 yr of age) sat reclining (head up) for 12 h in a chamber (21-23 degrees C dry bulb, 25-33% relative humidity) at 2800 m (9184 ft, 539 mm Hg) altitude (ALT), and at 321 m (1053 ft, 732 mm Hg) on the ground (GND). During 1000-1030 hours they consumed 3 fluids (12 ml x kg(-1),X = 948 ml x d(-1)) with large differences in sodium and osmotic contents: AstroAde (AA) with 185 mEq x L(-1) Na+ and 283 mOsm x kg(-1), Performance 1 (Shaklee) (P1) with 22 mEq x L(-1) Na+ and 365 mOsm kg(-1), or H2O at ALT; and only H2O on the GND.. After drinking: plasma volume (PV) increased at 1200 hours by 8.3% (p < 0.05) with AA but was not significantly (NS) changed in the other sessions (Xdelta = +0.9%, range -0.9 to 2.8%); p[Na+] and p[Osm] were unchanged. Urinary rates and free-water clearances were attenuated with AA and P1 vs. those with H2O. Correlations between and among p[Na+] and p[Osm] suggest that the pNa+ ion is more tightly controlled than pOsm; and that there was no clear hormonal response that could account for this dissociation from theoretical considerations.. There is significant dissociation between plasma sodium and osmotic concentrations after fluid intake. Induction and maintenance of hypervolemia requires increased (near isotonic) drink Na+ osmols rather than increased non-ionic osmols.

Topics: Adult; Altitude; Angiotensin II; Drinking Behavior; Humans; Male; Osmolar Concentration; Plasma Volume; Rehydration Solutions; Renin; Sodium; Thirst; Vasopressins; Water; Water Intoxication

Heart failure is a leading cause of morbidity and mortality. In the United States, there are more than 5 million patients with heart failure and over 500,000 newly diagnosed cases each year. Numerous advances have been made in our understanding of the pathophysiologic mechanisms contributing to sodium and water retention in this condition. Important alterations in the sympathetic nervous system and the renin-angiotensin-aldosterone system have been described in heart failure, allowing the use of mechanism-specific treatments such as beta-adrenergic receptor antagonism and angiotensin-converting enzyme inhibition. As our understanding of the roles of the natriuretic peptides and the arginine vasopressin-aquaporin-2 system in the pathophysiology of heart failure evolves, treatments directed toward the alterations in these systems in heart failure can be further developed.

Topics: Adrenergic beta-Antagonists; Angiotensin-Converting Enzyme Inhibitors; Atrial Natriuretic Factor; Body Fluids; Heart Failure; Humans; Natriuretic Peptide, Brain; Neurosecretory Systems; Renin-Angiotensin System; Sodium; Sympathetic Nervous System; Vasopressins; Water Intoxication; Water-Electrolyte Imbalance

1. Many polydipsic schizophrenics exhibit enhanced antidiuretic hormone (ADH) activity and thus are hyponatremic and suffer life-threatening water intoxication. Excess cortisol inhibits ADH, while cortisol insufficiency produces impairments in water balance resembling those seen in hyponatremic schizophrenics. Furthermore, hyponatremia normally upregulates cortisol receptors on the neurons which synthesize ADH, which should make them more sensitive to the effects of cortisol. 2. The author treated a hyponatremic schizophrenic, whose water imbalance was unresponsive to standard clinical interventions including clozapine, with a 4-week open trial of 60 mg cortisol daily, followed by a three week taper. 3. Mean serum sodium levels appeared to increase modestly from 114.3 to 118.5 mEq/l while the patient received adjunctive cortisol (P < .06). 4. While a modest effect was seen, the results do not suggest that adjunctive cortisol will reverse hyponatremia, and instead support other data indicating that these patients exhibit a central resistance to glucocorticoid actions.

Topics: Adult; Anti-Inflammatory Agents; Drinking Behavior; Humans; Hydrocortisone; Hyponatremia; Male; Schizophrenia; Sodium; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Polydipsia-hyponatremia is a poorly understood disorder that causes considerable mortality and morbidity. Hyponatremia in polydipsia-hyponatremia has been attributed to disturbances in antidiuretic hormone (ADH) function. Improvements in polydipsia-hyponatremia during clozapine treatment offered the chance to see if levels of ADH and other hormones associated with osmoregulation changed with improvement in biochemical and clinical measures of polydipsia-hyponatremia.. In this preliminary, longitudinal study, we studied 2 male schizophrenic patients (DSM-III-R) who had polydipsia-hyponatremia. Measures were (1) biochemical and clinical: serum sodium and osmolality, urine osmolality and specific gravity, normalized diurnal weight gain, and estimated urine volume and (2) endocrine: ADH, angiotensin II, atrial natriuretic peptide, and prolactin. Measures were collected during 2 months of baseline (typical neuroleptic) and 6 months of clozapine treatment.. Single-case statistical procedures showed significant changes in sodium levels (a.m. and p.m.), estimated urine volume, and a.m. urine specific gravity in both patients and significantly decreased diurnal weight gain in 1 patient. Both serum and urine osmolality showed improvement, but values did not reach statistical significance. Low baseline ADH levels persisted through 6 months of clozapine treatment and showed no changes in the context of improvements in serum sodium and osmolality. No significant changes were seen in levels of angiotensin II and atrial natriuretic peptide.. Given the limitations of this study, there is some evidence to suggest that the improvements in serum sodium and osmolality during clozapine treatment of polydipsia-hyponatremia may not be related to serum levels of ADH, although altered ADH receptor function cannot be ruled out. These data need to be extended in larger samples.

Topics: Adult; Angiotensin II; Atrial Natriuretic Factor; Circadian Rhythm; Clozapine; Humans; Hyponatremia; Longitudinal Studies; Male; Middle Aged; Osmolar Concentration; Prolactin; Schizophrenia; Sodium; Urine; Vasopressins; Water Intoxication

For unclear reasons, life-threatening water intoxication often coincides with acute psychosis in polydipsic schizophrenic patients with chronic hyponatremia. In contrast, most polydipsic schizophrenic patients are normonatremic and never manifest hyponatremia. To explore whether the effect of acute psychosis on water balance differs in these 2 schizophrenic subgroups, we compared their responses to drug-induced psychotic exacerbations.. Matched polydipsic schizophrenic patients with (n = 6) and without (n = 8) hyponatremia were identified based on past and current indexes of fluid intake and hydration. A transient psychotic exacerbation was induced with an infusion of the psychotomimetic methylphenidate hydrochloride (0.5 mg/kg of body weight over a 60-second period). Antidiuretic hormone levels, subjective desire for water, and factors known to influence water balance were measured at 15-minute intervals for 2 hours.. Except for the expected differences in plasma osmolality and sodium, basal measures were similar in the 2 groups. Following methylphenidate administration, antidiuretic hormone levels increased more in the hyponatremic patients (P < .02), despite their consistently lower plasma osmolality (P < .007). No known or putative antidiuretic hormone stimulus could account for this finding. Only basal positive psychotic symptoms (P < .09) and plasma sodium (P < .18) were even marginally associated with the peak antidiuretic hormone responses, but neither factor could explain the difference in the response by the 2 groups.. Psychotic exacerbations are associated with enhanced antidiuretic hormone secretion, for unknown reasons, in schizophrenic patients with hyponatremia and polydipsia, thereby placing them at increased risk of life-threatening water intoxication.

Topics: Acute Disease; Adult; Arginine Vasopressin; Blood Pressure; Drinking; Female; Heart Rate; Humans; Hydrocortisone; Hyponatremia; Inappropriate ADH Syndrome; Male; Methylphenidate; Osmolar Concentration; Psychiatric Status Rating Scales; Schizophrenia; Schizophrenic Psychology; Sodium; Thirst; Vasopressins; Water Intoxication

Topics: Hallucinogens; Humans; Hyponatremia; N-Methyl-3,4-methylenedioxyamphetamine; Vasopressins; Water Intoxication

An old women was in an 8-year-period 9 times admitted to the hospital because of severe mental disturbances. The average serum sodium concentration was 126.25 +/- 2.43 mmol/l at the admissions; it increased to 139.44 +/- 1.40 mmol/l after intravenous infusion of hypertonic solutions accompanied with the disappearance of the mental disturbances. The patient was usually chronically hyponatremic due to the increased water intake and the insufficient water excretion. The latter was induced by the augmented vasopressin levels. The remarkable feature of the syndrome of inappropriate antidiuretic hormone secretion was its association with lowered blood level of atrial natriuretic factor accompanied by sodium, and volume depletion. Discontinuation of the exaggerated water intake resulted in the elimination of the permanent hyponatremia; no episode of water intoxication occurred during the last 3 and 1/2 years.

Topics: Aged; Atrial Natriuretic Factor; Cognition Disorders; Drinking Behavior; Female; Humans; Hyponatremia; Inappropriate ADH Syndrome; Vasopressins; Water Intoxication

Topics: Drinking; Hippocampus; Humans; Neurocognitive Disorders; Schizophrenia; Schizophrenic Psychology; Stereotyped Behavior; Vasopressins; Water Intoxication

We describe a 71 year old man with a neurodegenerative condition who developed chronic inappropriate antidiuretic hormone secretion and hypothermia resulting in recurrent episodes of impaired consciousness. This combination of abnormalities is attributable to hypothalamic disease and has not to our knowledge been previously reported with clearly documented antidiuretic hormone excess.

Topics: Aged; Chronic Disease; Demyelinating Diseases; Humans; Hyponatremia; Hypothermia; Male; Vasopressins; Water Intoxication

A 70-year-old woman was admitted because of disturbance of her consciousness. Physical examinations and laboratory data suggested hypothyroidism. Primary hypothyroidism was subsequently confirmed with endocrinological examinations. Antidiuretic hormone (ADH) levels were elevated despite severe hyponatremia. On admission, urinary sodium concentration was 10mEq/l. The patient was treated with saline intravenously; serum sodium level increased from 120 to 125mEq/l and urinary sodium concentration increased from 10 to 54mEq/l. Mental confusion developed and serum sodium level dropped with urinary sodium concentration above 20mEq/l when thyroid replacement was started with the cessation of saline infusion. The patient's state of consciousness, elevated ADH levels, decreased serum sodium level and urinary sodium concentration were improved by thyroid replacement together with hydrocortisone therapy. Effects of acute water loading were abnormal with the administration of iodothyronine (T3) alone but were normalized with the administration of hydrocortisone together with T3. On discharge she was treated with the oral administration of levothyroxine alone. Pituitary hormones were normal. These results suggest that the patient was in a state of hypoadrenocorticism. Impaired water excretion in a state of hypoadrenocorticism due to hypothyroidism may give rise to an inappropriate secretion of ADH thereby resulting in hyponatremia, which in turn leads to hypotonic dehydration induced by water intoxication.

Topics: Adrenal Cortex; Adrenal Insufficiency; Aged; Dehydration; Female; Humans; Hyponatremia; Hypothyroidism; Vasopressins; Water Intoxication

Topics: Body Water; Dehydration; Diabetes Insipidus; Diuretics; Drinking; Feedback; Glomerular Filtration Rate; Homeostasis; Humans; Inappropriate ADH Syndrome; Polyuria; Vasopressins; Water Intoxication

Topics: Burns; Fluid Therapy; Humans; Hyponatremia; Infant; Male; Vasopressins; Water Intoxication

Carbamazepine (CBZ)-induced water intoxication occasionally limits its usefulness in refractory seizures and trigeminal neuralgia. Fluid restriction, CBZ dose reduction, or concomitant phenytoin therapy may be impractical or ineffective. Demeclocycline (7-chloro-6 demethyl tetracycline) (DMC) corrected the CBZ-induced water intoxication in a 51-year-old man with refractory complex partial seizures and a normal antidiuretic hormone (ADH) level. DMC inhibits ADH-sensitive adenylate cyclase activity in the renal collecting duct and may be useful in correcting the ADH-like or renal antidiuretic effect of CBZ.

Topics: Carbamazepine; Demeclocycline; Humans; Male; Middle Aged; Vasopressins; Water Intoxication

A new rat model of the Schwartz--Bartter syndrome was created by the administration of 1-deamino-8-D-arginine vasopressin together with a forced water intake. The treatment led to water retention, hypernatriuria, marked hyponatraemia (in 4-5 days) and severe cerebral oedema. These changes could be prevented by the simultaneous administration of [1-(beta-mercapto-beta, beta-cyclopentamethylene-propionic acid)- 2-o-ethyltyrosine-4-valine] arginine vasopressin. The observations indicate that this vasopressin antagonist analogue might be of use in the future as an effective drug against the Schwartz--Bartter syndrome.

Topics: Animals; Arginine Vasopressin; Deamino Arginine Vasopressin; Disease Models, Animal; Inappropriate ADH Syndrome; Male; Rats; Vasopressins; Water Intoxication

A study was conducted on 16 schizophrenic patients with compulsive water drinking (CWD) and 10 normal controls, and the relation between serum antidiuretic hormone (ADH) and serum osmolality measured under ordinary conditions of free water intake. A water deprivation test and a water load test were also carried out on 10 schizophrenics with CWD and 10 normal controls. A comparison between the patients and controls showed the following results: the patients showed a significantly high level of serum ADH for their serum osmolality level, and 3 of them were consistent with the syndrome of inappropriate secretion of ADH (SIADH); the urine osmolality after the water deprivation in the patients was relatively low for their serum ADH; inhibition of ADH secretion after the water load was insufficient in the patients; and the water load test proved favorable to water diuresis (106%) in the patients with CWD of less than a 5-year duration, and insufficient diuresis (62.6%) in the patients with CWD of more than a 5-year duration. Two cases of the latter group had SIADH. The dilution and concentration of the urine after the water load were delayed also in the schizophrenic patients without SIADH. These findings suggest a strong possibility that the regulatory mechanism of ADH secretion might be impaired in the schizophrenic patients with CWD.

Topics: Adult; Compulsive Behavior; Drinking; Female; Humans; Inappropriate ADH Syndrome; Male; Middle Aged; Schizophrenic Psychology; Vasopressins; Water Deprivation; Water Intoxication; Water-Electrolyte Balance

Topics: Humans; Mental Disorders; Schizophrenia; Vasopressins; Water Intoxication

The concentration of aldosterone in blood plasma of rats with chronic water and restricted sodium chloride intake substantially rose after subcutaneous injection of the antidiuretic hormone pituitrin in physiological doses. No simultaneous increase in blood corticosterone was seen. The production of hormones by rat adrenals remained unchanged. The results of experiments made with ACTH alone or combined with pituitrin permitted the conclusion that the increase in aldosterone concentration was not linked with a possible stimulation of endogenous ACTH secretion. The augmentation of aldosterone concentration in the peripheral blood of rats with chronic water intake induced by pituitrin is likely to be due to a decrease in metabolic clearance of the hormone.

Topics: Adrenocorticotropic Hormone; Aldosterone; Animals; Chronic Disease; Corticosterone; Diet, Sodium-Restricted; Male; Pituitary Hormones, Posterior; Rats; Vasopressins; Water Intoxication

The anti-diuretic action of carbamazepine, before and after concurrent treatment with demeclocycline, has been studied in a single epileptic subject, in whom two episodes of status epilepticus had been associated with excessive fluid intake and hyponatraemia. After addition of demeclocyline, free water clearance, plasma arginine vasopressin concentration and serum osmolality (all appreciably reduced after carbamazepine alone) increased but did not revert to normal. The findings are consistent with direct antagonism by demeclocycline of the enhancing effect of carbamazepine on endogenous ADH activity.

Topics: Adult; Carbamazepine; Demeclocycline; Female; Humans; Vasopressins; Water Intoxication

Topics: Adult; Drinking; Fever; Humans; Male; Psychophysiologic Disorders; Rhabdomyolysis; Vasopressins; Water Intoxication

It is very rare for disturbances of water balance to occur as isolated phenomena. More commonly, mixed electrolyte abnormalities present. However, to permit the logical application of therapy an understanding of basic water balance in health and disease is essential.

Topics: Dehydration; Diabetes Insipidus; Diabetes Mellitus; Humans; Osmolar Concentration; Thirst; Vasopressins; Water; Water Intoxication; Water Loss, Insensible; Water-Electrolyte Imbalance

A case of tuberculous Addison's disease presenting with psychosis, profound hyponatraemia, and detectable plasma antidiuretic hormone is reported. Clinical and biochemical improvement after corticosteroid replacement was followed by relapse with further psychosis and inappropriate antidiuretic hormone secretion: both were promptly reversed by demethylchlortetracycline. The association of psychological symptoms with Addison's disease, the role of anti-diuretic hormone secretion in Addison's disease, and the inter-relationship between Addison's disease, psychosis and anti-diuretic hormone secretion are discussed.

Topics: Addison Disease; Body Weight; Demeclocycline; Fludrocortisone; Humans; Hydrocortisone; Inappropriate ADH Syndrome; Male; Middle Aged; Psychotic Disorders; Vasopressins; Water Intoxication

Topics: Acute Disease; Adult; Alcoholism; Brain; Brain Diseases; Female; Humans; Magnetic Resonance Spectroscopy; Male; Middle Aged; Substance Withdrawal Syndrome; Vasopressins; Water Intoxication

Water intoxication with seizures secondary to excessive fluid ingestion occurred in four apparently healthy infants in two families; we also review five previously reported cases.

Topics: Diseases in Twins; Drinking; Female; Humans; Hyponatremia; Infant; Infant Care; Male; Seizures; Vasopressins; Water Intoxication

We have reviewed 14 cases of water intoxication in psychiatric patients. In these cases the possibility of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was suspected or diagnosed. The SIADH should be suspected in psychotic patients who drink water excessively, develop seizures, disorientation and deterioration of mental status.

Topics: Adult; Compulsive Behavior; Drinking; Female; Humans; Inappropriate ADH Syndrome; Male; Middle Aged; Neurocognitive Disorders; Psychotic Disorders; Psychotropic Drugs; Sodium; Vasopressins; Water Intoxication

Intravenous injection of 20 International Units (IU) of oxytocin in the form of synthetic oxytocin or neurohypophyseal extract preparations to dehydrated cows that had already undergone twelve hours of water withdrawal did not produce antidiuresis but rather rise of diuresis accompanied by saluretic effects. Increase in diuresis occurred also in hyperhydrated cows, following water application, provided that oxytocin or vasopressin preparations had caused antidiuresis and saluresis and, consequently, changed urine composition to osmotic pressures beyond the limit values between 650 and 750 mosmol/kg. Rehydration of cow may be associated with retardation of diuresis by four hours or more. If oxytocin or vasopressin are given in the phase of such rehydration, the period between water application and the onset of water diuresis may be defined as "blocked water diuresis". Continuous infusion of 0.34 or 0.8 IU of oxytocin per minute up to 3.5 hours did not cause water intoxication in hyperhydrated cows, though blood plasma values for osmotic pressure had dropped to 244 mosmol/kg, while Na+ concentration had gone down to 116 mmol/l.

Topics: Animals; Cattle; Cattle Diseases; Chlorides; Diuresis; Female; Kidney; Lactation; Osmotic Pressure; Oxytocin; Potassium; Pregnancy; Sodium; Vasopressins; Water Intoxication

Topics: Ascites; Demeclocycline; Edema; Humans; Hyponatremia; Osmolar Concentration; Vasopressins; Water Intoxication

In the present study, the effect of selective glucocorticoid deficiency on renal water excretion was investigated in conscious, trained, adrenalectomized dogs. The animals were studied before and after a water load while on replacement therapy of desoxycorticosterone acetate, 5 mg/day, and dexamethasone, 0.8 mg/day (group I), and while off dexamethasone for 5-9 days (group II). Before the water load the weight, inulin space, cardiac output, blood pressure, glomerular filtration rate, renal blood flow, plasma osmolality, and plasma antidiuretic hormone measured by radioimmunoassay were similar in both groups I and II. However, after a 40 ml/kg water load a marked impairment in renal water excretion in the glucocorticoid deficient dogs became apparent. Maximal free water clearance was -0.046+/-0.16 vs. 6.51+/-0.72 ml/min (P < 0.001) and minimal urinary osmolality was 425+/-56 vs. 82+/-3.5 mosmol/kg H(2)O (P < 0.001) in group II as compared to group I. Plasma antidiuretic hormone was maximally suppressed during the water load in group I to 0.34+/-0.08 pg/ml but remained elevated at 9.18+/-1.79 pg/ml (P < 0.005) in group II. This nonsuppressibility of plasma antidiuretic hormone during water loading in group II was associated with a significant tachycardia of 145+/-6 vs. 87+/-6 beats/min (P < 0.001) in group I and a significantly lower stroke volume of 27+/-0 vs. 59+/-0.5 ml/beat (P < 0.001). In conclusion, our results implicate a persistent secretion of antidiuretic hormone as an important factor in the impaired water excretion of glucocorticoid deficiency. A deleterious effect of glucocorticoid deficiency on cardiac function was observed and this hemodynamic alteration could be involved in initiating a nonosmolar, baroreceptor-mediated release of vasopressin.

Topics: Adrenalectomy; Animals; Blood Pressure; Body Weight; Cardiac Output; Dogs; Glomerular Filtration Rate; Glucocorticoids; Kidney; Osmolar Concentration; Vascular Resistance; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Adult; Deamino Arginine Vasopressin; Hemophilia A; Hemostasis, Surgical; Humans; Hyponatremia; Male; Tooth Extraction; Vasopressins; Water Intoxication

Topics: Adenylyl Cyclases; Animals; Deamino Arginine Vasopressin; Diabetes Insipidus; Diuresis; Enzyme Activation; Fluorides; Glucose; Guanine Nucleotides; Heterozygote; Kidney; Lypressin; Male; Rats; Species Specificity; Vasopressins; Water Intoxication

A review of the literature and the three presented cases indicate that multiple factors are often involved in the development of water intoxication in the psychotic. Although the syndrome of inappropriate secretion of antidiuretic hormones (SIADH) is one of these factors, it is usually associated with other causes of the SIADH. Evidence is lacking that the SIADH is an essential feature of a psychotic illness.

Topics: Delusions; Drinking Behavior; Fluphenazine; Humans; Hydrochlorothiazide; Male; Middle Aged; Psychotic Disorders; Sodium; Vasopressins; Water Intoxication

Topics: Aged; Arginine Vasopressin; Carbamazepine; Female; Humans; Vasopressins; Water Intoxication

Topics: Demeclocycline; Hormones, Ectopic; Humans; Vasopressins; Water Intoxication

Twenty-six patients with the syndrome of inappropriate secretion of antidiuretic hormone were reviewed. The underlying diseases were bronchogenic carcinoma (12 cases); myxoedema (five cases); diseases of the nervous system (five cases); bronchopneumonia, carcinoma of the oesophagus, acute intermittent porphria and chlorpropamide therapy (each one case). Serum sodium levels ranged between 104 and 125 mEq per litre. Eighteen patients presented neurological manifestations, which in 14 were considered to be due to hyponatraemia. Neurological signs included disorders of consciousness (stage I and II coma), extrapyramidal signs, asterixis and epileptic seizures. An hyponatraemic coma was the first manifestation of the syndrome in five cases. In all cases where the EEG was recorded it showed non-specific signs of metabolic coma. The fundi never showed signs of intracranial hypertension. Blood urea and creatinine levels were invariably low in the euthyroid patients; these values were normal or elevated in patients with myxoedema and hyponatraemia. Hypokalaemia was frequent, and hypocalcaemia constant. In eleven cases an excess of water intake revealed the clinical syndrome: six patients were excessive beer drinkers and five had received extensive intravenous infusions. In one case the deleterious effect of diuretics was evident, and in another, the syndrome became evident during radiotherapy of an oesophageal tumour. Treatment of the syndrome was successful in all cases. A review of the literature concerning the various pathogenic mechanisms corresponding to the different underlying diseases is presented. The concept of aberrant hormonal production by a tumour is illustrated by an electron microscopic study.

Topics: Adult; Aged; Carcinoma, Bronchogenic; Cerebrovascular Disorders; Esophageal Neoplasms; Female; Hormones, Ectopic; Humans; Hyponatremia; Hypothyroidism; Lung Neoplasms; Male; Middle Aged; Myxedema; Neurologic Manifestations; Vasopressins; Water Intoxication

Topics: Adolescent; Adult; Aged; Child; Female; Humans; Male; Middle Aged; Neurologic Manifestations; Syndrome; Vasopressins; Water Intoxication

Among the malignant tumors of nonendocrine origin that are capable of producing polypeptide hormones and of manifesting as different endocrine syndromes discussed here are ectopic ACTH syndrome, SIADH, and ectopic gonadotropin-producing tumors.

Topics: Adrenocorticotropic Hormone; Carcinoma, Hepatocellular; Carcinoma, Small Cell; Chorionic Gonadotropin; Cushing Syndrome; Diagnosis, Differential; Erythropoietin; Follicle Stimulating Hormone; Gynecomastia; Hormones, Ectopic; Humans; Hyperthyroidism; Hypoglycemia; Hyponatremia; Liver Neoplasms; Lung Neoplasms; Luteinizing Hormone; Male; Paraneoplastic Endocrine Syndromes; Polycythemia; Puberty, Precocious; Thyrotropin; Vasopressins; Water Intoxication

Topics: Accidents, Traffic; Adult; Anti-Bacterial Agents; Brain Concussion; Catheterization; Central Venous Pressure; Chlorides; Diabetes Insipidus; Female; Hemorrhage; Humans; Hydrogen-Ion Concentration; Infusions, Parenteral; Intracranial Pressure; Maxillofacial Injuries; Skull; Sodium; Urinary Catheterization; Vasopressins; Water; Water Intoxication

A case of excessive water retention after hypophysectomy is recorded. Its probable cause, inappropriate secretion of ADH, is explained and the diagnosis and management discussed. Three other recorded cases occurring after hypophyseal surgery are mentioned. The importance of postoperative electrolyte measurements in early diagnosis and management is emphasized.

Topics: Diuretics; Female; Humans; Hyponatremia; Hypophysectomy; Mannitol; Middle Aged; Vasopressins; Water Intoxication

Topics: Blood Volume; Body Water; Cell Membrane Permeability; Humans; Hyponatremia; Kidney Tubules, Proximal; Osmolar Concentration; Pituitary Gland, Posterior; Vasopressins; Water Intoxication; Water-Electrolyte Balance

The effect of different doses of clofibrate and carbamazepine on water metabolism was compared in a patient with psychogenic polydipsia. A definite relationship was found between the doses of both drugs and the antidiuretic effect. Daily 2--4 g clofibrate was ineffective, but 6--8 g induced the syndrome of inappropriate secretion of ADH. 600 mg carbamazepine a day induced a marked antidiuretic response which could be further augmented by administering daily 1200--1800 mg. The discrepancy between the effective "hypolipidemic" and "antidiuretic" dose of clofibrate may perhaps explain the lack of reports on water intoxication induced by this agent, despite of its entensive use in clinical practice.

Topics: Adult; Carbamazepine; Clofibrate; Diuresis; Dose-Response Relationship, Drug; Female; Glomerular Filtration Rate; Humans; Hyponatremia; Osmolar Concentration; Vasopressins; Water Intoxication

1. In order to study the effect of overhydration on body potassium, experiments were performed on pair-fed rabbits, one of which was maintained continuously on vasopressin and given extra water (60-90 ml day-1 kg-1) for 6-8 days, while the other served as control. 2. Overhydrated rabbits excreted significantly more potassium (53%) in their urine than control rabbits and accumulated a mean potassium deficit of 65-0 mmol, significantly higher than the mean value of 37-1 mmol in the control rabbits. 3. In the overhydrated rabbits, potassium fell significantly in both erythrocytes, from 266 to 173 mmol/kg of dry cells, and also in muscle, from 435 to 341 mmol/kg of fat-free dry solids. Neither changed significantly in the control animals. 4. Overhydration in the presence of vasopressin leads to potassium depletion in the rabbit and a similar phenomenon might be expected in man. Potassium depletion due to overhydration might account for the hypokalaemia and reduction in exchangeable potassium observed in some patients with the syndrome of inappropriate secretion of antidiuretic hormone.

Topics: Animals; Body Weight; Erythrocytes; Hypokalemia; Muscles; Osmolar Concentration; Potassium; Rabbits; Sodium; Urine; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Water depletion, water in excess and sodium depletion are the most important disturbance of sodium-water balance. Water, electrolytes and acid-base balance have always to be considered in their complex correlation because of their various interrdependency. The restoration of balance concerning imput and output is considered as a basic principle of any intravenous therapy.

Topics: Acid-Base Equilibrium; Extracellular Space; Humans; Infusions, Parenteral; Osmotic Pressure; Sodium; Vasopressins; Water Intoxication; Water Loss, Insensible; Water-Electrolyte Imbalance

Topics: Adrenal Insufficiency; Humans; Hyperglycemia; Hyperlipidemias; Hyponatremia; Pituitary Gland, Posterior; Syndrome; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Transient episodes of the syndrome of inappropriate anti-diuresis developped in two severe colchicine poisonings. These are the first cases reported. On patient also developped a reversible periphal neuropathy. The similarity of such accidents with vicristine neuro-toxicity is emphasized.

Topics: Adolescent; Alopecia; Bone Marrow Diseases; Diarrhea; Disseminated Intravascular Coagulation; Female; Humans; Hyponatremia; Psychomotor Disorders; Vasopressins; Water Intoxication; Water-Electrolyte Imbalance

In uncharacteristic clinical symptomatology the excess of water or the water intoxication render themselves conspicuous less by the signs of an increased fluid content than by central-nervous disturbances. Among the results of laboratory examinations the hypoosmolarity measured cryoscopically always, the hyponatraemia in most cases prove the excess of free water. Exceptions are discussed. A decreased capacity of the elimination of water pathogenetically plays a larger role than primarily excessive water supply. Apart from acute and chronic renal insufficiency the various forms of the Schwartz-Bartter-syndrome (inadequate ADH-secretion) play an increasingly more important role. The therapy demands the reduction of every supply of free water, the treatment of the evoking cause and only in cases of exception the administration of hypertonic saline solution, at the most dialysis treatment.

Topics: Diabetic Coma; Diagnosis, Differential; Humans; Kidney Diseases; Multiple Myeloma; Osmolar Concentration; Sodium; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Benzothiadiazines; Body Water; Carcinoma, Bronchogenic; Chlorpropamide; Dehydration; Diuretics; Edema; Humans; Hyponatremia; Sodium; Sodium Chloride Symporter Inhibitors; Vasopressins; Water Intoxication

Topics: Carbamazepine; Chlorpropamide; Clofibrate; Diabetes Insipidus; Diuretics; Drug Synergism; Drug Therapy, Combination; Humans; Vasopressins; Water Intoxication

Topics: Humans; Hyponatremia; Leukemia, Myeloid, Acute; Sodium; Vasopressins; Water Intoxication

Topics: Adult; Dementia; Female; Humans; Male; Middle Aged; Psychoses, Substance-Induced; Vasopressins; Water Intoxication

Topics: Adult; Female; Humans; Male; Middle Aged; Psychoses, Substance-Induced; Vasopressins; Water Intoxication

Topics: Adrenocorticotropic Hormone; Aldosterone; Catecholamines; Craniocerebral Trauma; Dehydration; Electrolytes; Glucagon; Glucose; Growth Hormone; Humans; Hydrocortisone; Hypernatremia; Hyponatremia; Metabolic Diseases; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Adaptation, Physiological; Animals; Brain; Desoxycorticosterone; Dexamethasone; Disease Models, Animal; Evaluation Studies as Topic; Male; Mannitol; Muscles; Osmolar Concentration; Permeability; Potassium; Potassium Isotopes; Rats; Sodium; Sodium Isotopes; Tritium; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Adult; Dehydration; Diet Therapy; Diuretics; Ethanol; Humans; Hypernatremia; Male; Muscular Diseases; Natriuresis; Osmolar Concentration; Paralysis; Potassium; Sodium; Vasopressins; Water Intoxication

Topics: Adult; Female; Humans; Pituitary Gland, Posterior; Schizophrenia; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Age Factors; Aldosterone; Desoxycorticosterone; Diuresis; Female; Fludrocortisone; Humans; Hyponatremia; Infant; Osmolar Concentration; Pituitary Diseases; Pituitary-Adrenal System; Renin; Seizures; Sodium Chloride; Vasopressins; Water Intoxication

Topics: Adrenocorticotropic Hormone; Animals; Biological Assay; Body Weight; Chromatography, Ion Exchange; Diabetes Insipidus; Drug Contamination; Drug Synergism; Female; Growth Hormone; Humans; Hyponatremia; Middle Aged; Rats; Swine; Vasopressins; Water Intoxication

Topics: Aged; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Male; Vasopressins; Water Intoxication

Topics: Aerosols; Blood Pressure; Breast; Costs and Cost Analysis; Diabetes Insipidus; Diuresis; Drug Combinations; Drug Hypersensitivity; Female; Humans; Intestines; Nose; Oxytocin; Tannins; Uterus; Vasopressins; Water Intoxication

Topics: Animals; Brain; Disease Models, Animal; Hyponatremia; Male; Muscles; Organ Size; Osmolar Concentration; Potassium; Rats; Sodium; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Diuretics; Extracellular Space; Humans; Hyperlipidemias; Hypoglycemia; Hyponatremia; Osmolar Concentration; Plasma Volume; Sodium; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Adult; Aged; Autopsy; Beer; Blood Urea Nitrogen; Coma; Diarrhea; Electroencephalography; Feeding and Eating Disorders; Female; Hemiplegia; Humans; Hypokalemia; Hyponatremia; Male; Middle Aged; Nutrition Disorders; Sodium; Tremor; Vasopressins; Vomiting; Water Intoxication

Topics: Aged; Chlorpropamide; Diabetes Mellitus; Female; Humans; Hyponatremia; Kidney Tubules; Male; Tolazamide; Vasopressins; Water Intoxication

Topics: Animals; Arginine; Biological Assay; Hemorrhage; Male; Osmolar Concentration; Pituitary Hormones, Posterior; Radioimmunoassay; Rats; Sodium Chloride; Vasopressins; Water; Water Deprivation; Water Intoxication; Water-Electrolyte Balance

Topics: Child; Drinking; Humans; Male; Opium; Toothache; Vasopressins; Water Intoxication

Topics: Blood; Dehydration; Homeostasis; Humans; Osmolar Concentration; Osmotic Pressure; Postoperative Complications; Surgical Procedures, Operative; Urine; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Aged; Chlorpropamide; Female; Humans; Hyponatremia; Natriuresis; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Carcinoma; Diagnosis, Differential; Exudates and Transudates; Female; Humans; Hyponatremia; Intestinal Obstruction; Middle Aged; Myxedema; Osmolar Concentration; Pelvic Inflammatory Disease; Pelvic Neoplasms; Sodium; Thyroid Hormones; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Acute Disease; Adult; Humans; Hyponatremia; Male; Middle Aged; Porphyrias; Syndrome; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Bronchial Neoplasms; Carcinoma; Electroencephalography; Humans; Hyponatremia; Middle Aged; Natriuresis; Neoplasm Metastasis; Vasopressins; Water Intoxication

Topics: Animals; Diuresis; Electrolytes; Female; Hypophysectomy; Kidney; Osmolar Concentration; Osmosis; Pituitary Gland; Rats; Triiodothyronine; Urine; Vasopressins; Water Intoxication

Topics: Animals; Dehydration; Hypothalamus; Oxytocin; Peptide Hydrolases; Rabbits; Vasopressins; Water Intoxication

Topics: Animals; Brain; Brain Edema; Extracellular Space; Microscopy; Microscopy, Electron; Microscopy, Phase-Contrast; Neuroglia; Neurons; Rats; Vasopressins; Water; Water Intoxication

Topics: Heart Failure; Humans; Hyponatremia; Vasopressins; Water Intoxication

Topics: Animals; Body Weight; Brain Chemistry; Brain Edema; Liver; Muscles; Rats; Vasopressins; Water; Water Intoxication; Water-Electrolyte Balance

Topics: Diabetes Insipidus; Humans; Hyponatremia; Male; Middle Aged; Psychophysiologic Disorders; Stress, Psychological; Vasopressins; Water Intoxication

Topics: Brain Neoplasms; Electroencephalography; Humans; Hyponatremia; Lung Neoplasms; Male; Middle Aged; Natriuresis; Neoplasm Metastasis; Vasopressins; Water Intoxication

Topics: Aged; Blood Urea Nitrogen; Chlorides; Humans; Male; Prostatic Hyperplasia; Sodium; Urination Disorders; Vasopressins; Water Intoxication

Topics: Adolescent; Adult; Aged; Female; Humans; Hyponatremia; Male; Middle Aged; Peripheral Nervous System Diseases; Polyneuropathies; Polyradiculopathy; Sodium; Vasopressins; Water Intoxication

Topics: Aged; Blood Proteins; Blood Urea Nitrogen; Chlorine; Creatinine; Diagnosis, Differential; Ethacrynic Acid; Female; Hormones, Ectopic; Humans; Hyponatremia; Mental Disorders; Potassium; Sodium; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Coma; Congenital Hypothyroidism; Female; Humans; Hyponatremia; Infant; Myxedema; Vasopressins; Water Intoxication

Topics: Brain Diseases; Bronchial Neoplasms; Humans; Hyponatremia; Vasopressins; Water Intoxication

Topics: Adolescent; Adult; Female; Hemodynamics; Humans; Oxytocin; Postpartum Period; Pregnancy; Vasopressins; Water Intoxication

Topics: Aged; Calcium; Coma; Dehydration; Humans; Magnesium; Potassium; Secretory Rate; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Aged; Humans; Male; Prostatitis; Secretory Rate; Urinary Catheterization; Urination Disorders; Vasopressins; Water Intoxication

Topics: Arginine Vasopressin; Clinical Laboratory Techniques; Coal Tar; Physiology; Polyradiculopathy; Renal Elimination; Therapeutics; Vasopressins; Water; Water Intoxication

Topics: Aerosols; Diabetes Insipidus; Diabetes Insipidus, Neurogenic; Diabetes Mellitus; Female; Humans; Hypersensitivity; Lypressin; Lysine; Pregnancy; Pregnancy in Diabetics; Toxicology; Vasopressins; Water Intoxication

Topics: Abortion, Induced; Diuresis; Female; Humans; Injections, Intravenous; Oxytocin; Pharmacology; Pregnancy; Seizures; Toxicology; Urine; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Heart Failure; Humans; Patient Discharge; Schizophrenia; Vasopressins; Water; Water Intoxication

Topics: Adrenocorticotropic Hormone; Androgens; Arginine Vasopressin; Cerebral Cortex; Cortisone; Desoxycorticosterone; Electroencephalography; Epilepsy; Pharmacology; Toxicology; Vasopressins; Water Intoxication; Water-Electrolyte Balance

Topics: Arginine Vasopressin; Humans; Polydipsia, Psychogenic; Thirst; Vasopressins; Water Intoxication