Li-Ng Melissa, Verbalis Joseph G
Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, DC, USA.
Core Evid. 2010 Jun 15;4:83-92. doi: 10.2147/ce.s5997.
The available treatment options for euvolemic and hypervolemic hyponatremia are limited, and consist mainly of fluid restriction, diuresis, or hypertonic solutions. Most of these therapies are neither well tolerated nor totally effective, and many are associated with significant adverse effects. Vasopressin receptor antagonists, also known as vaptans, are a new class of agents that now offer an additional treatment option for hyponatremic patients. Conivaptan hydrochloride, a competitive antagonist of vasopressin V1a and V2 receptors, is the first agent in this class to be approved for treatment of euvolemic and hypervolemic hyponatremia in hospitalized patients.
This review critically assesses the evidence that support the use of conivaptan for the treatment of patients with euvolemic and hypervolemic hyponatremia.
Conivaptan is effective in raising serum sodium levels in a predictable and safe fashion in euvolemic and hypervolemic hyponatremic patients. Conivaptan provides the first molecularly targeted approach for correcting hyponatremia in hospitalized patients.
对于血容量正常和血容量过多的低钠血症，现有的治疗选择有限，主要包括液体限制、利尿或高渗溶液。这些疗法大多耐受性不佳且并非完全有效，许多还伴有显著的不良反应。血管加压素受体拮抗剂，也称为托伐普坦类药物，是一类新型药物，为低钠血症患者提供了额外的治疗选择。盐酸考尼伐坦是血管加压素V1a和V2受体的竞争性拮抗剂，是该类药物中首个被批准用于治疗住院患者血容量正常和血容量过多性低钠血症的药物。
本综述批判性地评估支持考尼伐坦用于治疗血容量正常和血容量过多性低钠血症患者的证据。
考尼伐坦能以可预测且安全的方式有效提高血容量正常和血容量过多性低钠血症患者的血清钠水平。考尼伐坦为住院患者纠正低钠血症提供了首个分子靶向治疗方法。
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