What are some causes of true Na loss?
Diarrhoea and vomitting
Diuretics / renal failure
Peritonitis
Burns / CF
What are some causes of changes /imbalance in ADH secretion?
Heart failure Kidney failure Liver disease Meds Tumours (small cell lung carcinoma)
What drugs cause change in ADH / Na / water?
Thiazide, diuretics SSRIs PPIs ACE inhibitors Loop diuretics
How do you teat patients with low sodium?
Depends on the cause
Fluid restriction nearly always works (drink less).
Pontine demyelination - can occur with rapid correction of hyponatremia
Infusion of hypertonic saline + Ferosemide can be used in symptomatic patients.