A 41-year-old man with bipolar disorder on lithium monotherapy for 8 years presents with polyuria and polydipsia. Vital signs: BP 128/82 mmHg, HR 88/min, RR 16/min, temperature 37°C. Serum sodium 148 mEq/L; serum creatinine 0.9 mg/dL. Urine osmolality remains inappropriately low (180 mOsm/kg) after water deprivation and desmopressin administration, distinguishing this from central diabetes insipidus. Which medication most appropriately reduces his symptoms?
- A)Furosemide
- B)AmilorideGABARITO
- C)Phenylephrine
- D)Acetazolamide
- E)Mannitol
Explicação
Lithium can cause nephrogenic diabetes insipidus by entering principal cells through epithelial sodium channels. Amiloride blocks these channels and reduces lithium uptake, making it particularly useful in lithium induced nephrogenic diabetes insipidus. Ver explicação completa e trilha adaptativa →