Advances in Pharmacoepidemiology and Drug Safety

Nephrology, Busto Arsizio Hospital, Varese, Italy

Publications

• Review Article   
  The Tolvaptan Role on Acth Secretion and its Potential Therapeutic Implications
  Author(s): Ermira Cuka*
  
  Tolvaptan is an oral arginine vasopressin (AVP) receptor, antagonist. Due to its aquaretic properties, tolvaptan is indicated in the treatment of congestive heart failure, cirrhosis of the liver, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and autosomal dominant polycystic kidney disease (ADPKD). Studies in Cushing's disease and clinical observation in a patient with palmar hyperhidrosis dictate a tolvaptan role in the central nervous system (CNS) mainly through adrenocorticotropic hormone (ACTH) suppression. AVP receptors have a wide distribution in the body, including the CNS. Centrally AVP stimulates ACTH secretion by corticotrope cells which express all three vasopressin receptors (V1, V2 and, V3). ACTH is involved in both cortisol secretion and sympathetic nervous system activation. Cushing's disease is caused by prolonged exposure to high cortiso.. View more»
  

  Abstract PDF