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Informatics in Pharmacy

Disorders of Sodium

August 12, 2018 By Dr. G, PharmD

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Normal Sodium=136-145

Rapid changes in sodium can be life-threatening (demyelination seizures). Correct no more than 10-20 mEq in 24 hours.

Hypernatremia:

  • Determine fluid status and correct.
  • If acute (occuring over 1-3 days), lower 1-2 mEq/L/h over 24 hours.
  • If not acute, correct 0.5 mEq/L/hr over 48 hours.

Hypernatremia:

  • 3 % sodium: 100 cc bolus then 100 cc/hr or 1-2 cc/kg/hr to raise 1-2 mEq/hr. CENTRAL LINE ONLY.
  • Increase sodium by 2-2.5 for every 100 mg/dL over 100.
  • Increase sodium = [(infusate Na) – (Serum Na)] / (TBW +1)

Tolvaptan is discouraged in hyponateriam because hyponateriam returns after it’s discontinued.

Filed Under: Fluid, Electrolytes, & Nutrition

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia bcps Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020