Coupon Accepted Successfully!


Open Flashcards


8 out of 8

Drug used in treatment of cerebral salt wasting syndrome is?

A Desmopressin

B Conivaptan

C Fludrocortisone

D All of the above

Ans. C



1. While CSWS usually appears within the first week after brain injury and spontaneously resolves in 2–4 weeks,

2. It can sometimes last for months or years.

3. While fluid restriction is used to treat SIADH, CSWS requires aggressive hydration and correction of the low sodium levels using sodium chloride tablets. (volume for volume) (Ref: Nelson 18th edition 2302)

4. Sometimes, fludrocortisone (a mineralocorticoid) improves the hyponatremia.

Extra Edge:

Normal serum osmolality 500 – 800 mosmol/kg

Normal urine sodium 100 – 260 meq/day or >20 meq /l (Ref: Harrison, 18tth edition, Page 3603)

Adipsic Hypernatremia (Hari-18th Pg-2907)

Clinical Characteristics

1. A defect in the thirst mechanism results in adipsic hypernatremia, a syndrome characterized by chronic or recurrent hypertonic dehydration.

2. The hypernatremia varies widely in severity and usually is associated with signs of hypovolemia such as tachycardia, postural hypotension, azotemia, hyperuricemia, and hypokalemia.

3. Muscle weakness, pain, rhabdomyolysis, hyperglycemia, hyperlipidemia, and acute renal failure may also occur.

4. DI usually does not exist at presentation but may develop during rehydration.

Treatment: Adipsic hypernatremia should be treated by administering water orally if the patient is alert and cooperative or by using hypotonic fluids (0.45% saline or 5% dextrose and water) via IV if the patient is not.