Abstract
Despite being the most essential nutrient, water is commonly forgotten in the fields of pharmacy and nutrition. Hydration status is determined by water balance (the difference between water input and output). Hypohydration or negative water balance is affected by numerous factors, either internal (i.e., a lack of thirst sensation) or external (e.g., polypharmacy or chronic consumption of certain drugs). However, to date, research on the interaction between hydration status and drugs/excipients has been scarce. Drugs may trigger the appearance of hypohydration by means of the increase of water elimination through either diarrhea, urine or sweat; a decrease in thirst sensation or appetite; or the alteration of central thermoregulation. On the other hand, pharmaceutical excipients induce alterations in hydration status by decreasing the gastrointestinal transit time or increasing the gastrointestinal tract rate or intestinal permeability. In the present review, we evaluate studies that focus on the effects of drugs/excipients on hydration status. These studies support the aim of monitoring the hydration status in patients, mainly in those population segments with a higher risk, to avoid complications and associated pathologies, which are key axes in both pharmaceutical care and the field of nutrition.
Highlights
Among the different fields of physiology and nutrition, hydration does not always receive the attention it deserves
It is critical to consider that many patients are treated with a combination of angiotensin-converting enzyme inhibitors (ACEIs) and diuretics, either in a single drug delivery system or with two or more tablets, so that concomitant effects that alter water balance (WB) may appear, increasing the risk of developing complications derived from hypohydration
The available results suggest that drugs and excipients play an important role in the maintenance of hydration status
Summary
Among the different fields of physiology and nutrition, hydration does not always receive the attention it deserves. It is considered that drugs induce hypohydration by means of three mechanisms: (i) Decreasing thirst sensation, which leads to a decrease in liquid intake, (ii) increasing liquid elimination via urine, feces or sweat, and (iii) altering central thermoregulation [31]. There are different mechanisms by which drugs induce this effect, including affecting certain regulatory pathways in the gastrointestinal tract, allergic reactions, causing injuries in the intestinal tissue, shortening the gastrointestinal transit time, protein-loss through enteropathy and/or malabsorption or poor digestion of lipids and carbohydrates, among other mechanisms [35]. Some of these mechanisms may appear simultaneously. This well-known and internationally accepted method to classify drugs is based on the system or organ in which the drug exerts its pharmacological effect, its therapeutic indications and its chemical structure [38]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
