13. Vasopressin Receptor Antagonists
• RCTs showed sustained increase in plasma Na
compared to placebo
• Risk of hypotension with non-selective
antagonists
• V2 selective antagonists in trials
• No reports of osmotic demyelination
14. Osmotic Demyelination Syndrome
• Central pontine + extrapontine
• Over-enthusiastic correction of Na+
• In chronic hyponatraemia
– Brain tissue losses inorganic and organic solutes
– Takes few days
• Predisposing factors
– Alcoholism
– Malnourishment