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NBME 23 Answers

nbme23/Block 4/Question#22

A 40-year-old man with terminal small cell ...

Demeclocycline

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submitted by lfsuarez(66),

This patient presents with a small cell carcinoma which is very common for para neoplastic syndromes. In this case the cancer is causing SIADH. Demeclocyline is a tetracycline antibiotic that is also used to treat SIADH

gabeb71  To add to ^ It is widely used (though off-label in many countries including the United States) in the treatment of hyponatremia (low blood sodium concentration) due to the syndrome of inappropriate antidiuretic hormone (SIADH) when fluid restriction alone has been ineffective. Physiologically, this works by reducing the responsiveness of the collecting tubule cells to ADH. The use in SIADH actually relies on a side effect; demeclocycline induces nephrogenic diabetes insipidus (dehydration due to the inability to concentrate urine). +6