What is the emergency treatment for hyponatremia?
Patients with chronic hyponatremia and severe symptoms (eg, severe confusion, coma, seizures) should receive hypertonic saline, but only enough to raise the serum sodium level by 4-6 mEq/L and to arrest seizure activity. After this, we recommend no further correction of the sodium for the first 24 hours.
What is the pathophysiology of hyponatremia?
Pathogenesis of hyponatremia Hyponatremia results from the inability of the kidney to excrete a water load or excess water intake. Water intake depends upon thirst mechanism. Thirst is stimulated by increase in osmolality.
What is the best treatment for hyponatremia?
In general, hyponatremia is treated with fluid restriction (in the setting of euvolemia), isotonic saline (in hypovolemia), and diuresis (in hypervolemia). A combination of these therapies may be needed based on the presentation. Hypertonic saline is used to treat severe symptomatic hyponatremia.
Does hyponatremia require hospitalization?
Most patients undergoing therapy for hyponatremia will require hospitalization. Depending on the severity and acuity of the hyponatremia and nursing requirements, admission to the intensive care unit may be required.
How much water should I drink for hyponatremia?
The authors of the study report that hyponatremia symptoms can develop if a person drinks 3–4 liters of water in a short period, though they do not give a specific time estimate. According to one case report , soldiers developed symptoms after consuming at least 2 quarts (1.9 liters) of water per hour.
How is hyponatremia a symptom of MDMA use?
MDMA-induced hyponatremia occurs via multiple mechanisms; these include the induction of syndrome of inappropriate antidiuretic hormone secretion (SIADH), the encouragement to drink large amounts of water to prevent unpleasant side effects of the drug, and the tendency among those intoxicated to be involved in vigorous physical activity…
When to consider hyponatremia in an emergency room?
Hyponatremia must be considered in patients with pneumonia, active tuberculosis, pulmonary abscess, neoplasm, or asthma, as well as in patients with CNS infection, trauma, or neoplasm. Patients with carcinoma of the nasopharynx, duodenum, stomach, pancreas, ureter, prostate, or uterus also have an increased risk.
How is hyponatremia related to beer potomania?
Hyponatremia has been noted in patients with poor dietary intake who consume large amounts of beer (known as beer potomania) and after use of the recreational drug N- methyl-3,4-methylenedioxyamphetamine (ie, MDMA or ecstasy). MDMA-induced hyponatremia occurs via multiple mechanisms; these include the induction of syndrome…
How is conivaptan used in the treatment of hyponatremia?
Conivaptan, a V1A and V2 vasopressin receptor antagonist, is available only for intravenous use and is approved for use in the hospital setting for euvolemic and hypervolemic hyponatremia. It is contraindicated in hypovolemic patients. It induces both a water and sodium diuresis with improvement in plasma sodium levels.