Which medications in the drug class Electrolyte Supplements are used in the treatment of Hyponatremia in Emergency Medicine?

Updated: Dec 28, 2018
  • Author: Kartik Shah, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Electrolyte Supplements

Hypertonic saline may be used to rapidly increase serum sodium level in patients with severe acute or chronic hyponatremia, as manifested by severe confusion, coma, seizures, or evidence of brainstem herniation.

Hypertonic (3%) saline

Contains 513 mEq/L of NaCl. Volume of hypertonic saline administered depends on current and desired serum sodium levels and patient's weight. In general, increase of 4-6 mEq/L in serum sodium level is sufficient to arrest progression of symptoms in severe hyponatremia. Further rapid increase in serum sodium level not indicated.

Sodium bicarbonate

Commonly available ampoules are 8.4% sodium bicarbonate, with 1 ampoule containing 50 mEq of Na. This can be used to raise serum Na in an emergent scenario where 3% hypertonic saline is not readily available, such as a hyponatremic seizure. For comparison, 100 mL of 3% hypertonic saline contains 51.3 mEq of NaCl.


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