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Writer's pictureMark Nguyen, PharmD, BCEMP

Symptomatic Hyponatremia - #PHARMFAX

Hyponatremia can have a wide presentation, but life-threatening complications include seizures or coma.

 

Hyponatremia can have a wide presentation, but life-threatening complications include seizures or coma. The clinical approach hyponatremia is to first identify volume status, but right now, we've got a seizing patient in front of us. Generally, you want to avoid correcting hypernatremia by more than 10 mEq in 24 hours due to the risk of osmotic demyelination syndrome causing cerebral apoptosis. For severely symptomatic patients, correcting by 6 mEq/L in 1 - 2 hours keeps in a safe range. This can be achieved by giving 100 to 150 mL of 3% sodium chloride, which is a hypertonic solution. Shoot for running over 5 minutes per 50 mLs to safety administer 3% sodium chloride. Dosing can be repeated up to 2 to 3 times achieve serum sodium goal. We'll discuss the comparative continuous infusion strategy in another video. Desmopressin activates vasopressin 2 receptors, leading to retention of water in the kidney and maintenance of urinary sodium balance. Careful monitoring, fluid selection, and desmopressin improves you ability to safely treat severe hyponatremia. For more PHARMFAX in the drug bank, check out my website, pharmwyze.com


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