Which medication is most likely to contribute to hyponatremia in an older adult?

Which medication is most likely to contribute to hyponatremia in an older adult?

• A. Furosemide
• B. Digoxin
• C. Omeprazole
• D. Ciprofloxacin

Answer: (A)

Hyponatremia in older adults often stems from medications that disrupt sodium balance or promote excessive free water retention. A loop diuretic like furosemide increases the excretion of sodium and water in the kidneys, which can lead to volume depletion. That volume loss prompts a hormonal response that increases water reabsorption in the kidneys, diluting serum sodium and lowering its concentration. Older patients are especially susceptible due to reduced renal function, potential dehydration, and multiple meds that affect fluid balance. The other drugs listed don’t typically cause hyponatremia as a primary effect. Digoxin mainly alters cardiac Na+/K+ handling and doesn’t directly drive sodium loss or water retention in a way that produces hyponatremia; omeprazole and ciprofloxacin can be associated with electrolyte disturbances in rare cases but are not as common culprits as loop diuretics.

Hyponatremia in older adults often stems from medications that disrupt sodium balance or promote excessive free water retention. A loop diuretic like furosemide increases the excretion of sodium and water in the kidneys, which can lead to volume depletion. That volume loss prompts a hormonal response that increases water reabsorption in the kidneys, diluting serum sodium and lowering its concentration. Older patients are especially susceptible due to reduced renal function, potential dehydration, and multiple meds that affect fluid balance.

The other drugs listed don’t typically cause hyponatremia as a primary effect. Digoxin mainly alters cardiac Na+/K+ handling and doesn’t directly drive sodium loss or water retention in a way that produces hyponatremia; omeprazole and ciprofloxacin can be associated with electrolyte disturbances in rare cases but are not as common culprits as loop diuretics.