SIADH

• IV. SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE

  ● Syndrome of inappropriate antidiuretic hormone (SIADH) is overproduction of antidiuretic hormone by the posterior pituitary gland.

  ○ The opposite of diabetes insipidus which is less or no ADH

  ● This results in a decrease in urine production and water intoxication. As sodium levels fall in proportion to water, the child develops hyponatremia or a low sodium plasma level
• Possible Causes:

  1. Central nervous system infections such as bacterial meningitis

  2. Long-term positive pressure ventilation

  3. Pituitary compression from edema or tumor
• ASSESSMENT

  ● Weight gain because of excess ADH

  ● Concentrated urine with increased specific gravity

  ● Nausea and vomiting

  ● As hyponatremia grows more severe, coma or seizures occur from brain edema
• MANAGEMENT

  1. Restrict fluid.

  ● Because there is already water intoxiation

  2. Give supplemental Na by IV, if needed.

  ● Because of the hyponatremia.

  3. Administer Demeclocycline (Declomycin), a tetracycline antibiotic which has the side effect of blocking the action of ADH in renal tubules and reduces resorption of water

  ● This drug can increase urine output.