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Farm Hosp ; 37(3): 178-81, 2013.
Article in Spanish | MEDLINE | ID: mdl-23789795

ABSTRACT

PURPOSE: To analyse the effectiveness of the use of Tolvaptan and the adequacy of Tolvaptan prescription at a tertiary level hospital. METHODS: Prospective observational study of Tolvaptan prescrip - tion from October of 2010 to December of 2011. RESULTS: 30 patients (60.0% males) were included, 50.0% of which were diagnosed with heart failure and 30.0% with SIADH. Tolvaptan allowed achieving sodium levels higher than 135 mEq/L in 53.3% of the patients with a mean baseline value of 125.3±7.3 mEq/L. The median treatment duration was 5.0 days (interquartile range=3-45). A significant increase of uric acid associated to Tolvaptan treatment was observed. The prescription was in agreement to what has been established in GFT in 63.3% of the cases. CONCLUSIONS: Tolvaptan increases sodium levels by 7.5 mEq/L, both in SIADH-associated hyponatremia and in heart failure, with an appropriate safety profile.


Objetivo: Analizar la efectividad del uso de tolvaptán y la adecuación de su prescripción en un hospital de tercer nivel. Método: Estudio observacional prospectivo de las prescripciones de tolvaptán desde octubre de 2010 hasta diciembre de 2011. Resultados: Se incluyeron 30 pacientes (60,0% varones), 50,0% diagnosticados de insuficiencia cardíaca y 30,0% de SIADH. Tolvaptán permitió alcanzar niveles de sodio superiores a 135 mEq/L en el 53,3% de los pacientes que partían con una media de 125,3±7,3 mEq/L. La mediana de días de tratamiento fue de 5,0 (rango intercuartílico = 3-45). Se observó un incremento significativo de los niveles de ácido úrico asociado al tratamiento con tolvaptán. La prescripción se adecuó a lo establecido en la GFT en el 63,3% de los casos. Conclusiones: Tolvaptán incrementa un 7,5 mEq/L los niveles de sodio tanto en hiponatremia secundaria al SIADH como en insuficiencia cardiaca.


Subject(s)
Benzazepines/therapeutic use , Drug Prescriptions , Hyponatremia/drug therapy , Antidiuretic Hormone Receptor Antagonists , Benzazepines/administration & dosage , Benzazepines/adverse effects , Benzazepines/economics , Diuretics/administration & dosage , Diuretics/therapeutic use , Drug Costs , Drug Evaluation , Drug Prescriptions/economics , Drug Therapy, Combination , Female , Furosemide/administration & dosage , Furosemide/therapeutic use , Guideline Adherence , Heart Failure/blood , Heart Failure/complications , Humans , Hyponatremia/blood , Hyponatremia/etiology , Inappropriate ADH Syndrome/blood , Inappropriate ADH Syndrome/complications , Inpatients , Kidney Tubules, Distal/drug effects , Liver Cirrhosis/blood , Liver Cirrhosis/complications , Male , Natriuresis/drug effects , Pharmacy Service, Hospital/economics , Pharmacy Service, Hospital/statistics & numerical data , Practice Guidelines as Topic , Prospective Studies , Receptors, Vasopressin , Sodium/blood , Spain , Tertiary Care Centers/economics , Tertiary Care Centers/statistics & numerical data , Tolvaptan , Uric Acid/blood
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