SIADH
admin | Jan 18, 2010 | 2 comments
68 year old male, undergone TURP for BPH. In second post operation day he developed Nausea, headache and 2 episodes of vomiting .
Lab test shows
1. urinalysis : Sodium > 20 mmol/L, osmolality >500 mmol/kg
2.Serum : Na 125mmol/L, plasma osmolality <260 mosmol/kg
He was diagnosed as SIADH, and managed with giving demeclocycline and water restriction.
How demeclocycline works in SIADH (syndrome of inappropriate ADH secretion)?
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Filed Under: Discussion
Demeclocycline impairs the action of antidiuretic hormone in kidney but this mechanism is not completely understood, but it is thought that it blocks the binding of the hormone(ADH) to its receptor.
In the SIADH , there is increased ADH level.The increased ADH levels lead to insufficient elimination of water from the kidneys, and the retained water leads to dilution of the serum sodium concentration, a condition called hyponatremia, which leads to Nausea, headache and vomiting . so in order to treat BPH with other cancers drugs that leads to metabolic imbalance , so demeoclocycline is used to impair the ADH, and it is thought to work as dr ukesh thinks by blocking the ADH to its receptor and may cause reversible diabetes insipidus (dehydration due to the inability to concentrate urine)