Sodium hormones

The volume of extracellular fluid is direcdy related to the Na" concentration which is closely controlled by the kidneys. Homeostatic control of Na" concentration depends on the hormone aldosterone. The kidney secretes a proteolytic enzyme, rennin, which is essential in the first of a series of reactions leading to aldosterone. In response to a decrease in plasma volume and Na" concentration, the secretion of rennin stimulates the production of aldosterone resulting in increased sodium retention and increased volume of extracellular fluid (51,55). 

Reconstitution of T-ceU deficiencies with thymic hormones has not been successhil even though the various hormone preparations induce prothymocyte differentiation and functions of mature T-ceUs. They do not regulate the maturation of thymocytes in the thymus. In contrast, IL-2, endotoxin, thymic epithehal cell products, but not interleukin 1, were found to promote functional maturation of immature thymocytes. Two classes of dmgs show thymomimetic actions (Table 2). Levamisole [14769-73-4], sodium salt of diethyl dithiocarbamate (imuthiol) and certain... 

Fig. 2. Schematic representation of relevant electrolyte transport through the renal tubule, depicting the osmolar gradient ia medullary iaterstitial fluid ia ywOj yW where represents active transport, —passive transport, hoth active and passive transport, and passive transport of H2O ia the presence of ADH, ia A, the cortex, and B, the medulla. An osmole equals a mole of solute divided by the number of ions formed per molecule of the solute. Thus one mole of sodium chloride is equivalent to two osmoles, ie, lAfNaCl = 2 Osm NaCl. ADH = antidiuretic hormone.

The mineralocorticoids consist of aldosterone and des-oxycorticosterone and play an important role in conserving sodium and increasing die excretion of potassium. Because of diese activities, die mineralocorticoids are important in controlling salt and water balance Aldosterone is die more potent of these two hormones. Deficiencies of the mineralocorticoids result in a loss of sodium and water and a retention of potassium. 

MANAGING SODIUM AND WATER RETENTION. Sodium and water retention may occur during female hormone therapy, hi addition to reporting any swelling of die hands, ankles, or feet to the primary health care provider, die nurse weighs the hospitalized patient daily, keeps an accurate record of die intake and output, encourages ambulation (if not on bed rest), and helps the patient to eat a diet low in sodium (if prescribed by the primary health care provider). 

Regulatory role or role in hormone action Calcium, chromium, iodine, magnesium, manganese, sodium, potassium... 

Chorionic gonadotropin. Follicle stimulating hormone Urea, Uric add. Bilirubin, Cortisol, n-Maimitol. n-Glucose, Sodium pyruvate, 4-hydroxy-3-methoxy mandelic add, 4-Nitro-phenol, 17 Amino adds in HQ, Angiotensin-I, Tripahnitin, Bone meal (8 elements), Bone ash (8 elements), lithium carbonate Luteinizing hormone. Thyroid stimulating hormone... 

FIGURE 10-3. Expected neurohumoral response to hypovolemia. ACTH, adrenocorticotropic hormone ADH, antidiuretic hormone CNS, central nervous system Na, sodium. (Reprinted from Jimenez EJ. Shock. In Civetta JM, Taylor RW, Kirby RR, eds. Critical Care. New York Lippincott-Raven 1997 369, with permission.)... 

Oxcarbazepine Hyponatremia (serum sodium concentrations less than 125 mEq/L) has been reported and occurs more frequently during the first 3 months of therapy serum sodium concentrations should be monitored in patients receiving drugs that lower serum sodium concentrations (e.g., diuretics or drugs that cause inappropriate antidiuretic hormone secretion) or in patients with symptoms of hyponatremia (e.g., confusion, headache, lethargy, and malaise). Hypersensitivity reactions have occurred in approximately 25-30% of patients with a history of carbamazepine hypersensitivity and requires immediate discontinuation. 

ACE-I, angiotensin-converting enzyme inhibitor ADH, antidiuretic hormone (or vasopressin) ARB, angiotensin II receptor blocker, MESNA, sodium 2-mercaptoethanesulfonate TCA, tricyclic antidepressant Ul, urinary incontinence SUI, stress urinary incontinence UUI, urge urinary incontinence. 

Aldosterone A hormone produced in and secreted by the zona glomerulosa of the adrenal cortex. Aldosterone acts on the kidneys to reabsorb sodium and excrete potassium. It is also a part of the renin-angiotensin-aldosterone system, which regulates blood pressure and blood volume. 

Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) are members of a family of so-called natriuretic peptides, synthesized predominantly in the cardiac atrium, ventricle, and vascular endothelial cells, respectively (G13, Y2). ANP is a 28-amino-acid polypeptide hormone released into the circulation in response to atrial stretch (L3). ANP acts (Fig. 8) on the kidney to increase sodium excretion and glomerular filtration rate (GFR), to antagonize renal vasoconstriction, and to inhibit renin secretion (Ml). In the cardiovascular system, ANP antagonizes vasoconstriction and shifts fluid from the intravascular to the interstitial compartment (G14). In the adrenal cortex, ANP is a powerful inhibitor of aldosterone synthesis (E6, N3). At the hypothalamic level, ANP inhibits vasopressin secretion (S3). It has been shown that some of the effects of ANP are mediated via a newly discovered hormone, called adreno-medullin, controlling fluid and electrolyte homeostasis (S8). The diuretic and blood pressure-lowering effect of ANP may be partially due to adrenomedullin (V5). 

Aldosterone (183) is one of the key steroid hormones involved in regulation of the body s mineral and fluid balance. Excess levels of this steroid quickly lead to marked retention of sodium chloride, water and, often as a consequence, hypertension. The aldosterone antagonist spironolactone (184) has proven of great clinical value in blocking the effects... 

A nontrophic hormone acts on nonendocrine target tissues. For example, parathormone released from the parathyroid glands acts on bone tissue to stimulate the release of calcium into the blood. Aldosterone released from the cortical region of the adrenal glands acts on the kidney to stimulate the reabsorption of sodium into the blood. 

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