A 58-year-old man with small-cell lung cancer presents with severe symptomatic hyponatremia (serum sodium 118 mEq/L, osmolality 245 mOsm/kg). He is confused and has had one brief seizure. Urine osmolality is 580 mOsm/kg and urine sodium is 95 mEq/L. What is the drug of choice for acute symptomatic hyponatremia in this patient?

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