SYNDROME OF INAPPROPRIATE ADH SCERETION (SIADH)

ADH is secreted in response to hypovolumeia,in which case its secretion is appropriate.however,if ADH os secreted in high quantities in the presence of euvolemia or hypervolemia,it is called inappropriate secretion(SIADH).The resultant water retention can result in hyponatremia.Thus,
SIADH  is characterized by normovolemic or hypervolemic hyponatremia.

• Fluid restriction is treatment of choice for SIADH
• Hypertonic saline(3%Nacl)+ loop diuretics ( depending upon volume status) is treatment of choice for several symptomatic hyponatremia.
• Among drugs, tolvaptan(oral), conivaptan(i.v) are preferred for lomg term use.
• Alternatives are demeclocycline and lithium( not preffered now)

Q. Treatment of choice for SIADH is
A) Lithium carbonate
B) Demeclocycline
C) Vasopressin
D) Hypertonic saline
Ans: D ; Hypertonic saline