It has become readily apparent in recent years that a large number of drugs commonly used in the practice of medicine have the ability to cause impaired water excretion. In many cases, this effect is in addition to and unrelated to the primary pharmacologic property of the drug. The impaired water excretion resulting from use of the drug may cause significant hyponatremia and water intoxication, requiring termination of drug administration. With some drugs, the ability to impair water excretion has been utilized therapeutically in the treatment of diabetes insipidus. The drugs presently known to be capable of causing impaired water excretion in the mammalian kidney and, where known, the mechanism by which each drug acts are reviewed and discussed.
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