For severe hyponatremia due to SIADH, which therapy is used?

For severe hyponatremia due to SIADH, which therapy is used?

• A. Oral salt tablets
• B. IV hypertonic saline with furosemide
• C. Immediate rapid correction with water intake
• D. Demulcents

Answer: (B)

In severe hyponatremia from SIADH, the priority is to raise the serum sodium promptly to reverse brain edema while preventing too-rapid correction. IV hypertonic saline (3% NaCl) provides a controlled increase in sodium, addressing the acute neurologic risk. Adding a loop diuretic like furosemide promotes free-water excretion, helping to raise the sodium more predictably and limiting the chance of overshoot. This combination is therefore the appropriate therapy for severe, symptomatic SIADH. Oral salt tablets and rapid water intake would not rapidly correct the dangerous hyponatremia and could worsen symptoms or cause instability. Demulcents have no role in correcting electrolyte disturbances.

In severe hyponatremia from SIADH, the priority is to raise the serum sodium promptly to reverse brain edema while preventing too-rapid correction. IV hypertonic saline (3% NaCl) provides a controlled increase in sodium, addressing the acute neurologic risk. Adding a loop diuretic like furosemide promotes free-water excretion, helping to raise the sodium more predictably and limiting the chance of overshoot. This combination is therefore the appropriate therapy for severe, symptomatic SIADH.

Oral salt tablets and rapid water intake would not rapidly correct the dangerous hyponatremia and could worsen symptoms or cause instability. Demulcents have no role in correcting electrolyte disturbances.