It means an excessive
release of ADH
1. Physiology :
Refer to diabetes
insipidus.
2. Etiology :
a. Tumor → oat cell
carcinoma.
b. Pulmonary lesion
:Legionella pneumonia , T.B.
c. CNS : meningitis,
encephalitis & head injuries.
d. Drugs :
cholropropamide,carbamazepine,cyclophosphamide
-
3. C / P :
3. C / P :
· Increased ADH
causes water retention→ water
intoxication → dilutional
hyponatremia ( nausea,
vomiting, confusion,
headache, convulsions &
coma.)
· No edema
because of natriuresis.
4. Investigation :
1. ↓ Na (<
130m.Eq /L )
2. ↓ serum
osmolarity(< 270m.osmol/L.) &
↑urine
osmolarity (
> 300 m.osmol/L.)
N.B. : Normal
renal , adrenal & thyroid functions.
5. Treatment :
a. Fluid restriction → 800-1000 ml /
day.
b. demeclocycline:
i. 600-1200 mg /day → inhibit i
action of ADH.
ii. Given to patient
unresponsive to fluid restriction.
c. For sever hyponatremia
: hypertonic saline 1.8% slowly é
fursemide
to treat hyponatremia
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