Lets talk about a case of Na of 110 and seizure. Medications involved are mephobarbiturate and escitalopram( recent in last 2 years). The exam is consistent with euvolemia and you make a diagnosis of SIADH. Neuro status improves after receiving hypertonic saline and furosemide in the first 24 hours.
The Na corrects by 10Meq in the first 24 hours and another 20 meq by 36 hours. A little too rapid.
The urine output had just picked up. As a result, desmopression was administed and D5W to bring the Na down by 5Meq in 48 hours.
Would you attribute SIADH to lexapro?
What do you do when there is overcorrection?
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