Thiazide-Induced Hyponatrémie

Where there are thiazides will there also be Hyponatremia?  Today, this is not in question, but rather, where do you want to be when you have it. We have a French Female Flutist presenting to BMC via logan airport with a Na of 111.

Teaching Points:

• Differential for Hypotonic Hyponatremia by volume status.
• Mechanism of Hyponatremia via Thiazide use.
• Normal Saline for  asymptomatic patients versus 3% Hypertonic Saline for symptomatic patients.
• Rate of Na correction at 0.5 Meq/hr.
• Rare but potential complications of rapid overcorrection, ie Demyelination Syndrome.

Refrences: 1) Hyponatremia Treatment Guidelines 2007: Expert Panel Recommendations 2) coming..