Syndrome of inappropriate ADH

Tetracyclines block ADH in the kidney and especially demeclocycline is used to treat the syndrome of inappropriate ADH secretion. 

Syndrome of inappropriate ADH secretion (SIADH) PO Initially, 900-1200 mg/day in 3-4 divided doses, then decrease dose to 600-900 mg/day in divided doses. 

Amilohde and indomethacin are the most effective therapies for polyuria/polydipsia and syndrome of inappropriate ADH, respectively ( 77). 

Because CBZ can cause hyponatremia, it should be used cautiously in patients on a salt-restricted diet ( 373). Hyponatremia is rarely clinically significant when sodium values are above 125 mmol/L. Low sodium levels, as well as concomitant diuretic and lithium users, may predispose to the development of the syndrome of inappropriate ADH. Since CBZ enhances the effects of ADH, it can lead to impairment of free water clearance from the body. Older patients are at higher risk and should be closely monitored for this adverse effect which can be managed by dose reduction of CBZ. More severe cases, however, usually require switching to... 

Samman Y, Ghoneim H, Hashim IA. Syndrome of inappropriate ADH as a manifestation of severe ovarian hyperstimulation syndrome. J Obstet Gynaecol 2001 21 201-3. 

Stahel RA, Oelz O. Syndrome of inappropriate ADH secretion secondary to vinblastine. Cancer Chemother Pharmacol 1982 8(2) 253-4. 

In hypoosmotic hyponatremia with a normal volume status, the most common etiologies are the syndrome of inappropriate ADH (SIADH), primary polydipsia, hypothyroidism, and adrenal insufficiency (see Figure 46-2). SIADH is usually a result of ectopic or otherwise inappropriate ADH production arising from a variety of conditions (see Chapters 45 and 50) and results in excessive H2O retention. SIADH is often diagnosed when a urine osmolality that is greater than plasma osmolality (usually by more than >i00 mOsmol/kg) is observed in the setting of hyponatremia, but only when renal, adrenal, and thyroid functions are normal. Hypothyroidism impairs free H2O excretion, whereas in adrenal insufficiency, Na" is lost in preference to IC reabsorption. Finally, euvolemic hyponatremia can be... 

ADH antagonists oppose the actions of ADH and other naturally occurring peptides that act on the same Vj receptor. Such peptides are produced by certain tumors (eg, small cell carcinoma of the lung) and can cause significant water retention and dangerous hyponatremia. This syndrome of inappropriate ADH secretion (SIADH) can be treated with demeclocycline. Lithium also works but has greater toxicity. 

Toxicity Gastrointestinal distress, myelosuppression, and alopecia are expected adverse effects. Hemorrhagic cystitis due to the formation of acrolein may be decreased by vigorous hydration and by use of mercaptoethanesulfonate (mesna). Cyclophosphamide may also cause cardiac dysfunction, pulmonary toxicity, and a syndrome of inappropriate ADH secretion. 

Severe gastroenteritis (many poisons) Syndrome of inappropriate ADH (SIADH) ... 

Syndrome of inappropriate ADH secretion (SIADH). In patients with SIADH, ADH is secreted independently of volume or osmolality. Causes include malignancies, pulmonary disease, severe head injury, and some dmgs (see Table 1-26). The serum osmolality is low, but the urine osmolality is inappropriately increased (>300 mOsm/L). The serum blood urea nitrogen (BUN) is usually low (<10 mg/dL). 

Goodenough GK, Lutz LJ. Hyponatremic hypervolemia caused by a drug-drug interaction mistaken for syndrome of inappropriate ADH. JAm GeriatrSoc (1988) 36, 285-6. 

Endocrine Severe hyponatremia caused by the syndrome of inappropriate ADH secretion secondary to olanzapine has been reported [107" ] three other cases were reported to a Dutch pharmacovigilance center in 2006. 

Syndrome of Inappropriate ADH (SIADH), and Diabetes (Diabetic Ketoacidosis [DKA] and Hyperosmolar... 

The posterior lobe of the pituitary gland normally releases ADH in response to elevated serum osmolality to direct the kidneys to conserve water and restore fluid concentration balance. A condition referred to as the syndrome of inappropriate ADH (SIADH), in which there is an abnormal production or continued secretion of ADH, will result in excessive retention of water regardless of serum osmolality levels. The characteristic symptoms of SIADH are... 

Endocrine A 66-year-old woman with Parkinson s disease developed muscle weakness, anorexia, weight loss, and had severe hyponatremia due to the syndrome of inappropriate ADH secretion (SIADH) after taking amantadine after withdrawal the symptoms disappeared and the sodium concentration returned to normal [288" ]. 

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