. . "L\u00E9\u010Dba no\u010Dn\u00ED polyurie desmopresinem"@cs . "P\u0159i l\u00E9\u010Db\u011B no\u010Dn\u00ED polyurie vyu\u017E\u00EDv\u00E1me jak re\u017Eimov\u00E1 opat\u0159en\u00ED, tak i medikament\u00F3zn\u00ED l\u00E9\u010Dbu. Z\u00E1kladem medikament\u00F3zn\u00ED terapie je l\u00E9\u010Dba desmopresinem. Desmopresin acet\u00E1t je syntetick\u00FDm analogem antidiuretick\u00E9ho hormonu s vysokou afinitou k V2 receptor\u016Fm a antidiuretick\u00FDm \u00FA\u010Dinkem. V sou\u010Dasn\u00E9 dob\u011B je jedin\u00FDm registrovan\u00FDm prepar\u00E1tem pro l\u00E9\u010Dbu antidiuretiky. Oproti antidiuretick\u00E9mu hormonu nem\u00E1 desmopresin \u017E\u00E1dnou relevantn\u00ED afinitu k V1 receptor\u016Fm, a tedy ani \u017E\u00E1dn\u00FD hypertenzn\u00ED \u00FA\u010Dinek. Po u\u017Eit\u00ED desmopresinu v dob\u011B p\u0159ed usnut\u00EDm je b\u011Bhem sp\u00E1nku sn\u00ED\u017Eena tvorba mo\u010Di, a proto je prodlou\u017Een \u010Das do nucen\u00ED na mo\u010Den\u00ED a po\u010Det nykturi\u00ED. Klinick\u00FD efekt ve smyslu sn\u00ED\u017Een\u00ED objemu vytvo\u0159en\u00E9 mo\u010Di a zv\u00FD\u0161en\u00E9 osmolality mo\u010Di trv\u00E1 p\u0159ibli\u017En\u011B 8\u201312 hodin. Desmopresin se k l\u00E9\u010Db\u011B no\u010Dn\u00ED polyurie aplikuje peror\u00E1ln\u011B jednu hodinu p\u0159ed span\u00EDm. Optim\u00E1ln\u00ED d\u00E1vku desmopresinu je t\u0159eba vytitrovat, l\u00E9\u010Dba se zahajuje d\u00E1vkou 60 ?g prepar\u00E1tu v tzv. MELT form\u011B (fast melting oral formulation \u2013 rychle rozpustn\u00E1 tabletov\u00E1 forma) a m\u016F\u017Ee se podle klinick\u00E9ho \u00FA\u010Dinku po t\u00FDdnu zvy\u0161ovat do maxim\u00E1ln\u00ED doporu\u010Den\u00E9 d\u00E1vky 240 ?g. Pacienti l\u00E9\u010Den\u00ED desmopresinem by m\u011Bli sn\u00ED\u017Eit p\u0159\u00EDjem tekutin 1 hodinu p\u0159ed aplikac\u00ED a 8 hodin po aplikaci desmopresinu. Celkov\u00FD po\u010Det ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F spojen\u00FDch s pod\u00E1v\u00E1n\u00EDm desmopresinu byl v proveden\u00FDch klinick\u00FDch studi\u00EDch vy\u0161\u0161\u00ED ne\u017E u placeba, ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky byly v\u011Bt\u0161inou m\u00EDrn\u00E9ho stupn\u011B. Nej\u010Dast\u011Bji ud\u00E1van\u00E9 ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky v kr\u00E1tkodob\u00FDch a dlouhodob\u00FDch studi\u00EDch byly bolesti hlavy, nauzea, pr\u016Fjem, bolesti b\u0159icha, z\u00E1vrat\u011B, pocit sucha v \u00FAstech a hyponatr\u00E9mie. Hyponatr\u00E9mie byla v klinick\u00FDch studi\u00EDch pozorov\u00E1na p\u0159edev\u0161\u00EDm u pacient\u016F ve v\u011Bku vy\u0161\u0161\u00EDm ne\u017E 65 let, proto by l\u00E9\u010Dba desmopresinem nem\u011Bla b\u00FDt u t\u011Bchto pacient\u016F zah\u00E1jena bez monitorov\u00E1n\u00ED hladiny natria a v\u0161ichni pacienti by m\u011Bli b\u00FDt tak\u00E9 pou\u010Deni o prodromech hyponatr\u00E9mie \u2013 bolestech hlavy, nauzee a insomnii."@cs . "Nocturnal polyuria; treatment; desmopressin"@en . . . "Zachoval, Roman" . "4"^^ . "1"^^ . "\u010Cesk\u00E1 gynekologie" . "CZ - \u010Cesk\u00E1 republika" . "Nocturnal polyuria, treatment with desmopressin"@en . . "84555" . "V" . "78" . "Nocturnal polyuria, treatment with desmopressin"@en . . "L\u00E9\u010Dba no\u010Dn\u00ED polyurie desmopresinem" . . "[3A6EBED2E6FE]" . "1805-4455" . "10"^^ . . "RIV/00064190:_____/13:#0000706!RIV14-MZ0-00064190" . . . "RIV/00064190:_____/13:#0000706" . "L\u00E9\u010Dba no\u010Dn\u00ED polyurie desmopresinem" . . . . "Nonpharmacologic and especially pharmacologic treatment options are available for nocturnal polyuria. Desmopressin represents the basis of pharmacologic treatment. Desmopressin acetate is a synthetic analogue of arginine vasopressin with high affinity to V2 receptors with antidiuretic effect. It is the only medicament currently registered for antidiuretic treatment. Desmopressin has not any relevant affinity to V1 receptors, and therefore there is no hypertensive effect in contrary to natural vasopressin. Desmopressin use before a bedtime leads to reduced production of urine during a sleep, therefore time between desires to void is prolonged and number of nocturia is reduced. Clinical effect, in a meaning of reduced urine production and increased osmolality of urine, lasts approximately 8-12 hours. In the treatment of nocturnal polyuria desmopressin is used orally one hour before a bedtime. It is essential to titrate an ideal dose, the initial dose is 60 ?g of MELT formula (fast melting oral formulation) and it can be increased according to the clinical effect up to the maximal recommended daily dose 240 ?g. Patients treated with desmopressin should cut down a fluid intake 1 hour before and 8 hours after the use of desmopressin. Total number of adverse events connected withdesmopressin treatment in clinical studies was higher compared to placebo but the side effects were mostly mild. The most common adverse events were headaches, nausea, diarrhoea, abdominal pain, dry mouth and hyponatremia both in the short-term and long-term clinical trials. Hyponatremia was observed mainly in patients over 65 year of age. Therefore treatment with desmopressin should not be commended in patients over 65 year of age without close monitoring of the natrium level in serum and all patients should be informed about the first symptoms of hyponatremia \u2013 headache, nausea and insomnia."@en . . . "4" . "L\u00E9\u010Dba no\u010Dn\u00ED polyurie desmopresinem"@cs . "P\u0159i l\u00E9\u010Db\u011B no\u010Dn\u00ED polyurie vyu\u017E\u00EDv\u00E1me jak re\u017Eimov\u00E1 opat\u0159en\u00ED, tak i medikament\u00F3zn\u00ED l\u00E9\u010Dbu. Z\u00E1kladem medikament\u00F3zn\u00ED terapie je l\u00E9\u010Dba desmopresinem. Desmopresin acet\u00E1t je syntetick\u00FDm analogem antidiuretick\u00E9ho hormonu s vysokou afinitou k V2 receptor\u016Fm a antidiuretick\u00FDm \u00FA\u010Dinkem. V sou\u010Dasn\u00E9 dob\u011B je jedin\u00FDm registrovan\u00FDm prepar\u00E1tem pro l\u00E9\u010Dbu antidiuretiky. Oproti antidiuretick\u00E9mu hormonu nem\u00E1 desmopresin \u017E\u00E1dnou relevantn\u00ED afinitu k V1 receptor\u016Fm, a tedy ani \u017E\u00E1dn\u00FD hypertenzn\u00ED \u00FA\u010Dinek. Po u\u017Eit\u00ED desmopresinu v dob\u011B p\u0159ed usnut\u00EDm je b\u011Bhem sp\u00E1nku sn\u00ED\u017Eena tvorba mo\u010Di, a proto je prodlou\u017Een \u010Das do nucen\u00ED na mo\u010Den\u00ED a po\u010Det nykturi\u00ED. Klinick\u00FD efekt ve smyslu sn\u00ED\u017Een\u00ED objemu vytvo\u0159en\u00E9 mo\u010Di a zv\u00FD\u0161en\u00E9 osmolality mo\u010Di trv\u00E1 p\u0159ibli\u017En\u011B 8\u201312 hodin. Desmopresin se k l\u00E9\u010Db\u011B no\u010Dn\u00ED polyurie aplikuje peror\u00E1ln\u011B jednu hodinu p\u0159ed span\u00EDm. Optim\u00E1ln\u00ED d\u00E1vku desmopresinu je t\u0159eba vytitrovat, l\u00E9\u010Dba se zahajuje d\u00E1vkou 60 ?g prepar\u00E1tu v tzv. MELT form\u011B (fast melting oral formulation \u2013 rychle rozpustn\u00E1 tabletov\u00E1 forma) a m\u016F\u017Ee se podle klinick\u00E9ho \u00FA\u010Dinku po t\u00FDdnu zvy\u0161ovat do maxim\u00E1ln\u00ED doporu\u010Den\u00E9 d\u00E1vky 240 ?g. Pacienti l\u00E9\u010Den\u00ED desmopresinem by m\u011Bli sn\u00ED\u017Eit p\u0159\u00EDjem tekutin 1 hodinu p\u0159ed aplikac\u00ED a 8 hodin po aplikaci desmopresinu. Celkov\u00FD po\u010Det ne\u017E\u00E1douc\u00EDch \u00FA\u010Dink\u016F spojen\u00FDch s pod\u00E1v\u00E1n\u00EDm desmopresinu byl v proveden\u00FDch klinick\u00FDch studi\u00EDch vy\u0161\u0161\u00ED ne\u017E u placeba, ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky byly v\u011Bt\u0161inou m\u00EDrn\u00E9ho stupn\u011B. Nej\u010Dast\u011Bji ud\u00E1van\u00E9 ne\u017E\u00E1douc\u00ED \u00FA\u010Dinky v kr\u00E1tkodob\u00FDch a dlouhodob\u00FDch studi\u00EDch byly bolesti hlavy, nauzea, pr\u016Fjem, bolesti b\u0159icha, z\u00E1vrat\u011B, pocit sucha v \u00FAstech a hyponatr\u00E9mie. Hyponatr\u00E9mie byla v klinick\u00FDch studi\u00EDch pozorov\u00E1na p\u0159edev\u0161\u00EDm u pacient\u016F ve v\u011Bku vy\u0161\u0161\u00EDm ne\u017E 65 let, proto by l\u00E9\u010Dba desmopresinem nem\u011Bla b\u00FDt u t\u011Bchto pacient\u016F zah\u00E1jena bez monitorov\u00E1n\u00ED hladiny natria a v\u0161ichni pacienti by m\u011Bli b\u00FDt tak\u00E9 pou\u010Deni o prodromech hyponatr\u00E9mie \u2013 bolestech hlavy, nauzee a insomnii." .