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Trimethoprim-sulfamethoxazole (TMP-SMX) is a commonly prescribed antibiotic used at
high doses for treatment of pneumocystis pneumonia and other infections. Trimethoprim
is structurally related to the potassium-sparing diuretic amiloride and has been associated
with hyperkalemia and hyponatremia through blocking of epithelial sodium channels
in the distal nephron. The incidence of hyponatremia in hospitalized patients treated
with high-dose TMP-SMX is unknown.