Hyper-Hyponatremia Drugs (Wolff)

Question 1

Hyponatremia Symptoms

Answer 1

SALT LOSS
S - Stupor
A - Anorexia
L - Lethargy
T - Tendon relfexes decreased
L - Limp muscles (weakness)
O - Orthostatic hypotension
S - Seizures
S - Stomach cramping

Question 2

Vaptans MOA

Answer 2

increase free water clearance by blocking antidiuretic hormone (ADH) receptor in the collecting duct

Question 3

Conivaptan

Answer 3

non-peptide arginine vasopressin receptor antagonist that promotes the excretion of free water; indicated in euvolemic and hypervolemic hyponatremia; too rapid correction can lead to ODS

Question 4

Tolvaptan

Answer 4

oral V2 receptor antagonist given to patients ONLY in a hospital; must use < 30 days for hyponatremia; potentially fatal hepatotoxicity; used to slow ADPKD

Question 5

Hypernatremia symptoms

Answer 5

TRIP
T -Twitching, tremors, hyperreflexia
R - Restlessness, irritable, confusion
I - Intense thirst, dry mouth, decreased urine output
P - Pulmonary and peripheral edema

Question 6

Treatment for hypernatremia

Answer 6

if hypovolemic - isotonic saline
other patients - hypotonic IV solutions (D5W)

Question 7

Drug used to slow progression of adult polycystic kidney disease

Answer 7

Tolvaptan (V2 receptor antagonist)

Question 8

Desmopressin (DDAVP)

Answer 8

synthetic ADH; V2 selective agonist; indicated in central diabetes insipidus and primary nocturnal enuresis; may cause HYPOnatremia - can be life-threatening

Question 9

What life-threatening complication can arise from desmopressin administration?

Answer 9

HYPOnatremia - leading to seizures, coma, respiratory arrest and death

Question 10

Which drug has a potentially fatal hepatotoxicity?

Answer 10

Tolvaptan (V2 receptor antagonist)