{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:52:22Z","timestamp":1761094342922,"version":"build-2065373602"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,1,10]],"date-time":"2013-01-10T00:00:00Z","timestamp":1357776000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:sec><jats:title>Study Objective<\/jats:title><jats:p>To determine the natremic response of a single 20\u2010mg bolus dose of conivaptan, an arginine vasopressin antagonist, in hyponatremic neurosurgical patients with the syndrome of inappropriate antidiuretic hormone secretion (<jats:styled-content style=\"fixed-case\">SIADH<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective medical record review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Neurosurgical intensive care unit of a tertiary care referral hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Thirty\u2010two hyponatremic patients with SIADH who were admitted to the neurosurgical intensive care unit and received a single 20\u2010mg bolus dose of conivaptan between January and December 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>Each patient's natremic response over 48\u00a0hours was determined. The primary end point was an increase in serum sodium level of 4\u00a0mEq\/L or greater over the first 24\u00a0hours. The mean \u00b1 SD baseline serum sodium level was 129.8\u00a0\u00b1\u00a03.4 mEq\/L, which increased to 133.1\u00a0\u00b1\u00a03.2\u00a0mEq\/L at 6\u00a0hours after administration of the bolus dose of conivaptan. The serum sodium level at 24\u00a0hours was 134.2\u00a0\u00b1\u00a03.2\u00a0mEq\/L, indicating a 24\u2010hour natremic response of 4.3\u00a0\u00b1\u00a02.6\u00a0mEq\/L (range 1\u201313\u00a0mEq\/L) from baseline (p&lt;0.001). Eighteen patients (56%) met the primary end point. The mean \u00b1 SD fluid balance over the first 24\u00a0hours was \u2013783\u00a0\u00b1\u00a0440 ml. The mean \u00b1 SD change in serum sodium level from 24 to 48\u00a0hours was 0.5\u00a0\u00b1\u00a01.3\u00a0mEq\/L. No adverse effects or injection\u2010site reactions were noted. The patients who failed to reach the primary end point were treated with repeated doses of conivaptan plus other agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We recommend a single 20\u2010mg dose of conivaptan as the preferred initial approach to treating patients with <jats:styled-content style=\"fixed-case\">SIADH<\/jats:styled-content> who are in the neurosurgical intensive care unit. The 24\u2010hour natremic response should then dictate whether additional doses of conivaptan or other therapeutic interventions are required. We believe that such an approach is safe and will result in a controlled and predictable increase in the serum sodium concentration.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.1169","type":"journal-article","created":{"date-parts":[[2013,1,10]],"date-time":"2013-01-10T08:47:27Z","timestamp":1357807647000},"page":"51-55","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Therapeutic Effect of Conivaptan Bolus Dosing in Hyponatremic Neurosurgical Patients"],"prefix":"10.1002","volume":"33","author":[{"given":"Paul E.","family":"Marik","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Eastern Virginia Medical School Norfolk Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Racquel","family":"Rivera","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Sentara Norfolk General Hospital Norfolk Virginia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,1,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000358954.62182.B3"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2006.02432.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200211000-00028"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(00)00622-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp066837"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.8.16.2729"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2007.09.001"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000106456"},{"key":"e_1_2_6_10_1","unstructured":"Astellas Pharma US Inc. 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