Pediatric Hyponatremia Medication

Updated: Dec 21, 2020
  • Author: Muthukumar Vellaichamy, MD, FAAP; Chief Editor: Timothy E Corden, MD  more...
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Medication Summary

Medical therapy in hyponatremia includes the administration of 3% Na chloride (Na, 513 mEq/L), normal Na chloride solution (Na, 154 mEq/L), diuretics, and other drugs used to treat syndrome of inappropriate antidiuretic hormone secretion (SIADH), such as lithium carbonate, demeclocycline, ethanol, phenytoin, and vasopressin analogs. [18]



Class Summary

These agents promote renal excretion of water and electrolytes. They are used to treat heart failure or hepatic, renal, or pulmonary disease when Na and water retention results in edema or ascites.

Furosemide (Lasix)

Potent loop diuretic. Inhibits reabsorption of sodium and chloride in proximal and distal tubules and loop of Henle. High efficacy largely due to unique site of action. Action on distal tubule independent of any possible inhibitory effect on carbonic anhydrase or aldosterone.


ADH inhibitors

Class Summary

These agents produce diuresis by inhibiting antidiuretic hormone (ADH)-induced water reabsorption. Rarely used to treat pediatric hyponatremia in the pediatric ICU setting.

Lithium (Eskalith, Lithobid)

Inhibits renal response to ADH.

Demeclocycline (Declomycin)

Only tetracycline used to treat SIADH. Produces diuresis by inhibiting ADH-induced water reabsorption in distal portion of convoluted tubules and collecting ducts of kidneys. Effects observed within 5 d and are reversed 2-6 d after cessation of therapy. Administer 1 h before or 2-3 h after ingestion of milk or food.

Phenytoin (Dilantin)

Inhibits secretion of ADH.