DIABETES INSIPIDUS-MANAGEMENT
SUMMARY
1. Neurogenic DI: desmopressin (intranasal, oral, SC).
2. Nephrogenic DI: low-salt diet, thiazide diuretics +/- amiloride.
ADIPSIC HYPERNATREMIA
3. Adipsic hypernatremia: if the thirst and ADH osmoreceptors are damaged, a patient has recurrent hypematremic dehydration without thirst. ADH does not increase with increasing osmolality but does respond to all the other stimulants.
4. To exclude, observe whether the patient develops thirst as serum osmolality increases.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].