Abstract
A significant amount of clinicians’ time is spent
managing patients with complications arising from the
use of sympatheticomimetic drugs such as cocaine and
ecstasy, or MDMA. This article examines one of these
complications, namely acute hyponatraemia, which
can have life-threatening neurological consequences.
Although there are few signs or symptoms of this
condition, emergency clinicians should be able to
recognise when it may have occurred, and should
have a basic understanding of the role of sodium in
autoregulation of cellular function, the different fluid
compartments in the human body and the pathology of
cerebral oedema. The article describes the importance
of early recognition and swift treatment of acute
hyponatraemia, as well as the methods for calculating
fluid replacement to optimise chances of full recovery.