Emergency Med Medical News about hyponatremia

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Hyponatremia in Psychiatric Patients: Update on Evaluation and Management
Harvard Review of Psychiatry, 03/12/09

Siegel AJ. - Based on the role of arginine vasopressin (AVP) in the development of hyponatremia, further studies are warranted to determine the efficacy of the AVP-receptor antagonists in psychiatric patients with hyponatremia.

Methods

MEDLINE was used to identify peer-reviewed publications that described the role of arginine vasopressin (AVP) in the pathogenesis of hyponatremia, the presentation and treatment of hyponatremia in psychiatric patients, and promising new treatment options.

Results

Polydipsia may lead to hyponatremia in patients with schizophrenia, which is mediated, in part, by a reduced osmotic threshold for the release of AVP and by a defect in the osmoregulation of thirst.
Acute-onset hyponatremia may require emergent treatment with hypertonic (3%) saline, whereas chronic cases mandate gradual correction to minimize the risk of osmotic demyelination.
The AVP-receptor antagonists, including conivaptan, tolvaptan, lixivaptan, and satavaptan, represent a therapeutic advance in the treatment of dilutional hyponatremia.

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Hyponatremia in Neurosurgical Patients: Clinical Guidelines Development
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Prevention of Hyponatremia during Maintenance Intravenous Fluid Administration: A Prospective Randomized Study of Fluid Type versus Fluid Rate
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Hyponatremia in Heart Failure
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New aspects in the pathogenesis, prevention, and treatment of hyponatremic encephalopathy in children
Pediatric Nephrology, 11/11/09 Relevance Score: 80%