PMID: 16614541Apr 15, 2006Paper

Vasopressin antagonism: potential impact on neurologic disease

Clinical Neuropharmacology
Alejandro A Rabinstein

Abstract

Hyponatremia is a common electrolyte disorder frequently associated with central nervous system (CNS) diseases, neurosurgical procedures, and the use of neurotropic drugs. The clinical manifestations of hyponatremia are attributable to an increase in brain water content that occurs in response to a decrease in serum osmolality. Hyponatremia triggers adaptive processes in the brain to limit this cerebral swelling, but a rapid fall in serum [Na(+)] may overwhelm this adaptive mechanism. Patients with hyponatremia for more than 48 hours are at risk for developing osmotic demyelination when overly rapid correction of hyponatremia restores serum osmolality before this adaptive process can be reversed. The infusion of hypertonic saline for the restoration of serum [Na(+)] should therefore be carefully controlled to avoid this potentially devastating complication. Other options currently available for the treatment of hyponatremia, including strict restriction of fluid intake, are limited by their inconsistent response, poor tolerability, and frequent adverse effects. Arginine vasopressin (AVP)-receptor antagonists promote aquaresis (electrolyte-sparing excretion of free water) by blocking the antidiuretic action of the hormone at the...Continue Reading

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Citations

Oct 12, 2011·Current Neurology and Neuroscience Reports·Jennifer E Fugate, Alejandro A Rabinstein
Jan 6, 2009·Neurocritical Care·Theresa MurphyMichael Diringer
Jul 13, 2011·Neurocritical Care·Alejandro A Rabinstein, Nicolas Bruder
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Dec 27, 2019·Clinical and Experimental Pharmacology & Physiology·Marta AleksandrowiczEwa Kozniewska
Mar 20, 2018·Pflügers Archiv : European journal of physiology·Marta Aleksandrowicz, Ewa Kozniewska
Dec 1, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Natalie F Holt, Kenneth L Haspel

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