Clofibrate Diuretics

The most common cause of hyponatremia in hospital patients is SIADH. However, other disorders can cause dilutional hyponatremia and must be differentiated from SIADH. These conditions include (1) congestive heart failure, (2) renal insufficiency, (3) nephrotic syndrome, (4) liver cirrhosis, and (5) hypothyroidism. Excessive administration of hypotonic fluids and treatment with drugs that stimulate AVP (e.g., chlorpropamide, vincristine, clofibrate, carbamazepine, nicotine, phenothiazines, and cyclophosphamide) can cause dilutional hyponatremia as well. Hyponatremia may also occur from renal or extrarenal sodium losses (depietional hyponatremia) as a result of vomiting, diarrhea, excessive sweating, diuretic abuse, saltlosing nephropathy, or mineralocorticoid deficiency. 

Among the numerous discoveries that we owe to botanists and pharmacognosts are the development of tryptophan metabolites, and especially indolylacetic acid. This compound acts as growth hormone in plants. Para-chlorinated phenoxyacetic acids (MCPA or methoxone 2,4-D or chloroxone) are mimics of indolylacetic acid (bioisostery) and show similar phytohormonal properties at high doses they serve as weeders. Ring-chlorinated phenoxyacetic acids were later introduced in molecules as varied as meclofenoxate (cerebral metabohsm), clofibrate (Upid metabolism) and ethacrynic acid (diuretic). 

Rado JP, Szende L, Marosi J, Juhos E, Sawinsky I, Tako J. Inhibition of the diuretic action of glibenclamide by clofibrate, carbamazepine and l-deamino-8-D-aiginine-vasopressin (DDAVP) in patients with pituitary diabetes msipidm. Acta DiabetalLat 974) 11,179-97. 

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