Hypernatremia Medication

Updated: Jan 04, 2021
  • Author: Ivo Lukitsch, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Medication

Medication Summary

Some patients with nephrogenic diabetes insipidus—particularly those in whom it is mild or incomplete—may benefit from diuretic therapy (eg, thiazides, loop-diuretics) in an effort to increase proximal tubular reabsorption and decrease delivery to diluting segments where water may be lost. Inhibition of cyclooxygenase by nonsteroidal anti-inflammatory drugs (NSAIDs) may attenuate the polyuria in these patients. In addition, any medications that may cause nephrogenic diabetes insipidus (such as lithium) may require discontinuation.

In patients with central diabetes insipidus, desmopressin administered orally or intranasally may be used. Pharmacologic agents can be used in partial central diabetes insipidus to increase circulating AVP. These drugs include chlorpropamide, clofibrate, and carbamazepine.

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Diuretics

Class Summary

These drugs may be used to enhance sodium excretion.

Hydrochlorothiazide (Esidrix, HydroDiuril, Microzide)

Inhibits the reabsorption of sodium in the distal tubules, causing increased excretion of sodium and water, as well as of potassium and hydrogen ions.

Furosemide (Lasix)

Loop diuretic that increases excretion of water by interfering with chloride-binding cotransport system, which in turn inhibits sodium and chloride reabsorption in ascending loop of Henle and distal renal tubule. Increases renal blood flow without increasing filtration rate. Onset of action generally is within 1-h. Increases potassium, sodium, calcium, and magnesium excretion.

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Vasopressin analogs

Class Summary

These agents may enhance sodium excretion.

Desmopressin (DDAVP)

Increases cellular permeability of collecting ducts, resulting in the reabsorption of water by the kidneys.

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