Tolvaptan:一种新的治疗代理。
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Aperis G, Alivanis P
Tolvaptan:一种新的治疗代理。
牧师最近的试验。2011;6 (2):177 - 88。
- PubMed ID
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20868352 (在PubMed]
- 文摘
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Tolvaptan是一个新的代理治疗normovolemic和hypervolemic低钠血症。这是一个V(2)受体拮抗剂引起自由水利尿。它最近在美国和欧洲批准用于治疗低钠血症与SIADH,肝硬化以及心力衰竭,而在低血容量性低钠血症是禁忌使用。毒品也似乎能有效缓解心力衰竭急性加重,需要住院治疗。在短期内tolvaptan似乎减轻急性充血性症状和提高死亡率。然而,长期对死亡率的影响仍然是有争议的。良好的短期效果被归结为选择性V(2)受体阻断,而无对手的刺激V(1)给出的解释缺乏长期受益。药物应该开始在医院设置建议因为仔细监测液体平衡。口服给予门诊延续的优势。此外tolvaptan可能有作用的治疗常染色体显性遗传性多囊肾病(ADPKD)。 Its effectiveness has been shown in animal models and Phase 3 clinical trial as well as an open-label study is now active. Since tolvaptan is metabolized by the cytochrome CYP3A4 in the liver physicians should be aware of possible drug to drug interactions. Resulting from large studies tolvaptan appears well tolerated. Common side effects are thirst, dry mouth and polyuria. Tolvaptan opens a new page not only in the treatment of normovolemic and hypervolemic hyponatremia but also in the treatment of acute decompensated heart failure and probably in ADPKD.