A 66-year-old woman on SSRIs presents with serum sodium 122 mmol/L, euvolaemic exam, low serum osmolality and inappropriately concentrated urine. She ...

Question

A 66-year-old woman on SSRIs presents with serum sodium 122 mmol/L, euvolaemic exam, low serum osmolality and inappropriately concentrated urine. She is mildly confused but haemodynamically stable. What is the most appropriate initial management?

Accepted Answer

Fluid restriction and review of medications for possible causes

Answer

Rapid correction with hypertonic saline to normal sodium within 6 hours

Answer

High-dose loop diuretics with free water intake

Answer

No treatment is needed for asymptomatic hyponatraemia

Answer

Immediate dialysis

ca-mccqe1 MCQ (SBA): Hyponatraemia (SIADH)

A 66-year-old woman on SSRIs presents with serum sodium 122 mmol/L, euvolaemic exam, low serum osmolality and inappropriately concentrated urine. She is mildly confused but haemodynamically stable. What is the most appropriate initial management?