{
  "abstract": "Many older adults attending the emergency department (ED) take medications that interfere with water and electrolyte balance. This narrative review, based on a structured PubMed/MEDLINE search covering January 2016 to September 2026, summarizes evidence on drug-associated disorders of sodium, potassium, magnesium and calcium in older ED patients. Thiazides, antidepressants, antiepileptic drugs, antipsychotics, proton pump inhibitors and desmopressin are associated with hyponatremia; with thiazides, the risk peaks in the first weeks of treatment and is highest in women aged 80 years or older. Lithium can cause nephrogenic diabetes insipidus, which may persist after discontinuation and cause hypernatremia when water intake is inadequate. Renin–angiotensin–aldosterone system inhibitors, mineralocorticoid receptor antagonists, trimethoprim and non-steroidal anti-inflammatory drugs predispose to hyperkalemia, particularly in chronic kidney disease; diuretics and proton pump inhibitors are associated with hypokalemia and hypomagnesemia; and denosumab can cause severe hypocalcemia in advanced kidney disease. Most of this evidence is observational, and drugs usually act together with comorbidities, acute illness and other medications. We propose a severity-based ED algorithm integrating medication history, laboratory, electrocardiographic and volume assessment (including point-of-care ultrasound) to guide stabilization, drug adjustment, safe correction and disposition. ED-based medication safety programs reduce inappropriate prescribing, but their effect on electrolyte-related outcomes remains unproven.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania",
    "Emergency Unit, County Emergency Hospital Resita, 320154 Resita, Romania",
    "ENT Department, County Emergency Hospital Resita, 320154 Resita, Romania",
    "Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania",
    "Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania",
    "Department VIII, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania",
    "Department II of Microscopic Morphology, Discipline of Histology, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania",
    "Department XIII, Discipline of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania",
    "Centre for Artificial Intelligence and Big Data in Emergency Medicine and Clinical Research, Department of Surgery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania",
    "Department of Surgery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania",
    "ENT Department, Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania",
    "Radiology Department, Emerald Medical Center, Corneliu Coposu Boulevard 14, 300552 Timisoara, Romania"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Alexandru Cristian Brici"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Maria Octavia Murariu"
    },
    {
      "affs": [
        3
      ],
      "name": "Alexia Manole",
      "orcid": "0009-0005-3410-3870"
    },
    {
      "affs": [
        4
      ],
      "name": "Raul Patrascu"
    },
    {
      "affs": [
        5
      ],
      "name": "Vera Ciocan"
    },
    {
      "affs": [
        6
      ],
      "name": "Dorin Novacescu",
      "orcid": "0000-0002-2520-7636"
    },
    {
      "affs": [
        7
      ],
      "name": "Talida Georgiana Cut",
      "orcid": "0000-0002-6567-4407"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "Alina Petrica",
      "orcid": "0000-0002-0699-710X"
    },
    {
      "affs": [
        10
      ],
      "name": "Felicia Manole",
      "orcid": "0000-0002-2153-1148"
    },
    {
      "affs": [
        6
      ],
      "name": "Flavia Zara",
      "orcid": "0000-0002-5755-179X"
    },
    {
      "affs": [
        6
      ],
      "name": "Cristina Stefania Dumitru",
      "orcid": "0000-0001-8933-3060"
    },
    {
      "affs": [
        11
      ],
      "name": "Marius Liviu Moise"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8ngqct76x6y6e.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218719",
  "fulltext_url": null,
  "id": "8ngqct76x6y6e",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8719",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-08",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/8ngqct76x6y6e.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T00:21:41Z",
      "native_id": "10.3390/jcm15218719",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8719"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Drug-Induced Electrolyte Disturbances in Older Adults Presenting to the Emergency Department: Mechanisms, Recognition and Prevention",
  "title_text": "Drug-Induced Electrolyte Disturbances in Older Adults Presenting to the Emergency Department: Mechanisms, Recognition and Prevention",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T00:21:41Z",
  "url": "https://research.draconitic.com/paper/8ngqct76x6y6e",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}