Description

Euvolemic hyponatremia — Euvolemic hyponatremia caused by SIADH, is characterized by a high Uosm (>100 mosm/L) and a high UNa (>30 mEq/L). Treatment with salts tabs is not an option as Mederia and Chang (2014) agree that patients with highly concentrated urine (Uosm >500 mosm/L) will not respond as well to the salt load, because the kidneys will continue to excrete much of the sodium in a concentrated urine.In such patients, a loop diuretic can be used to help excrete free water, because it decreases the Uosm to about ½ NS (154 mOsm/L). Begin treatment with loop diuretic, Furosemide 20mg IV TID, strict I&O’s, and use Gatorade instead of water for hydration. Q3H BMP to trend Na+. Ethanol and BAC to r/o potomania. Drug-induced hyponatremia — Second generation antipsychotics (SGAs) are known to induce hyponatremia, in this case they could delay the treatment plan and correction of hyponatremia.