Diabetes Insipidus: The Daily PANCE Blueprint

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Diabetes Insipidus: The Daily PANCE Blueprint

A patient on lithium develops polyuria & polydipsia. Which drug is preferred for lithium-induced nephrogenic DI by blocking ENaC channels?

A. Hydrochlorothiazide
B. Desmopressin (DDAVP)
C. Furosemide
D. Amiloride
E. Indomethacin

Answer and topic summary

The answer is D. Amiloride.

Lithium is a classic cause of nephrogenic diabetes insipidus (DI). It enters the principal cells of the kidney’s collecting ducts via the epithelial sodium channel (ENaC) and interferes with the ADH signaling pathway, causing an inability to concentrate urine. Amiloride, a potassium-sparing diuretic, specifically blocks this ENaC channel. This prevents lithium from entering the cells, directly treating the mechanism of lithium-induced DI.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Endocrinology ⇒ Pituitary Disorders ⇒ Diabetes insipidus

Also covered as part of the Internal Medicine EOR and Emergency Medicine PAEA EOR topic list

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