Answer
Maintenance of adequate fluid intake is the most important therapy for all causes of DI that can result in hypernatremia. Hormonal and pharmacologic therapies must be tailored for the specific causes of DI (eg, central, nephrogenic). Central DI is treated with replacement therapy of ADH. The therapy for nephrogenic DI depends on reducing urine volume with combinations of salt restriction, thiazide diuretics, and prostaglandin synthetase inhibitors.
The other causes of hyponatremia do not require medications beyond hypotonic fluid for correction.
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Media Gallery
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Figure A: Normal cell. Figure B: Cell initially responds to extracellular hypertonicity through passive osmosis of water extracellularly, resulting in cell shrinkage. Figure C: Cell actively responds to extracellular hypertonicity and cell shrinkage in order to limit water loss through transport of organic osmolytes across the cell membrane, as well as through intracellular production of these osmolytes. Figure D: Rapid correction of extracellular hypertonicity results in passive movement of water molecules into the relatively hypertonic intracellular space, causing cellular swelling, damage, and ultimately death.
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