Finch Christopher K, Kelley Kristi W, Williams Raela B
Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, AL, USA.
Pharmacotherapy. 2003 Apr;23(4):546-50. doi: 10.1592/phco.23.4.546.32121.
A 63-year-old African-American woman was admitted to the hospital with urosepsis and altered mental status. She had a history of schizophrenia and was treated with olanzapine 5 mg/day and lithium carbonate 300 mg 3 times/day. During her hospital stay, her sodium level and serum osmolality increased and her urine osmolality decreased, whereas her lithium levels remained within normal limits. Based on these findings, the patient was diagnosed with diabetes insipidus secondary to lithium therapy and was treated successfully with amiloride. Clinicians have been aware of lithium toxicity for many years and traditionally have administered thiazide diuretics for lithium-induced polyuria and nephrogenic diabetes insipidus. Recently, amiloride, a potassium-sparing diuretic, has been reported as a successful treatment for nephrogenic diabetes insipidus.
一名63岁的非裔美国女性因尿脓毒症和精神状态改变入院。她有精神分裂症病史，接受奥氮平5毫克/天和碳酸锂300毫克每日3次的治疗。在住院期间，她的血钠水平和血清渗透压升高，尿渗透压降低，而她的锂水平仍在正常范围内。基于这些发现，该患者被诊断为锂治疗继发的尿崩症，并使用阿米洛利成功治疗。临床医生多年来一直知晓锂中毒情况，传统上一直使用噻嗪类利尿剂治疗锂诱导的多尿和肾性尿崩症。最近，有报道称，保钾利尿剂阿米洛利是治疗肾性尿崩症的成功药物。
