I gave the patient from yesterday 30 mg of tolvaptan. The repeat sodium was 128, up from 124 and urine sodium was down to 70, from 148 and the potassium was 40, down from 48. Urine output rose to 3425 mL.
The electrolyte free water clearance went from negative 1,364 to positive 481 mL.
Tolvaptan FTW.
The SIADH is due to West Nile Virus induced encephalitis.
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That's interesting,
Tolvaptan has promising results in terms of increasing free water clearance but the real questions for how long would u continue it?
Do keep us updated. It will be interesting to see the outcome.
Thanks for the Post.
J
This is a patient with encephalitis as the cause of SIADH. As his sodium was falling everyday you have the problem of what is his continuing altered mental status due to: primary infectious process or his increasing dysnatremia. I wanted to correct the sodium to eliminate that from a possible cause of his altered mental status.