title: Sublingual desmopressin is efficient and safe in the therapy of lithiasic renal colic.
abstract: OBJECTIVE
  To evaluate the effects of newer sublingual desmopressin administration in lithiasic renal colic, alone or combined with a nonsteroidal anti-inflammatory drug (NSAID).
  
  
  METHODS
  Prospective single-blind study including an initial number of 249 patients with lithiasic renal colic was randomized as follows: group NSAID (71 patients) received ketorolac tromethamine (ketorolac) 30 mg im and sublingual placebo (vitamin C), groups D1 and D2 (57 and 62 patients) received sublingual desmopressin (Minirin Melt), 60 and 120 μg, respectively, whereas group C (59 patients) received a combination of 30 mg im ketorolac and 60 μg sublingual desmopressin. Pain intensity was assessed using the visual analogue scale before and thirty minutes after drug administration. Patients experiencing pain aggravation were rescued and excluded from the study.
  
  
  RESULTS
  Dropout incidence was higher in the NSAID group than in the groups treated with desmopressin in monotherapy or combined with ketorolac (p < 0.05). Pain intensity was diminished at least as potently by the monotherapy with desmopressin and ketorolac. The higher dose of desmopressin and the combination therapy decreased pain intensity with 56 and 59%, respectively, significantly more than the 47% decrease obtained with ketorolac alone (p < 0.05 and p < 0.001). Mean pain decrease was higher in the combination group (C) than in the NSAID or D1 groups (p < 0.001 and p < 0.05, respectively), suggesting drug additivity. Patients did not experience severe side effects.
  
  
  CONCLUSIONS
  Sublingual desmopressin is at least as potent as NSAID in the treatment of lithiasic renal colic. The combination of sublingual desmopressin and NSAID has additive analgesic effects.
authors.affiliation: Department of Urology, "Gr. T. Popa" University of Medicine and Pharmacy Iasi, 16th Universitatii St, 700115, Iasi, Romania.
authors.forename: Catalin
authors.initials: C
authors.lastname: Pricop
authors.affiliation: Department of Endocrinology, "Gr. T. Popa" University of Medicine and Pharmacy Iasi, 16th Universitatii St, 700115, Iasi, Romania.
authors.forename: Dumitru D
authors.initials: DD
authors.lastname: Branisteanu
authors.affiliation: Department of Urology, Tg. Mures University of Medicine and Pharmacy, 38th Gheorghe Marinescu St, 540139, Tg Mures, Romania. orsolya.martha@yahoo.com.
authors.forename: Martha
authors.initials: M
authors.lastname: Orsolya
authors.affiliation: Department of Urology, "C.I. Parhon" Clinical Hospital, 50th Carol Bd., 700503, Iasi, Romania.
authors.forename: Dragos
authors.initials: D
authors.lastname: Puia
authors.affiliation: Department of Endocrinology, "St. Spiridon" Emergency Hospital, 1st Independentei Bd., 700106, Iasi, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Matei
authors.affiliation: Department of Nephrology and Dialysis, Clinical Department No. 3, "Carol Davila" University of Medicine and Pharmacy Bucharest, 37th Dionisie Lupu St, Sector 1, 020022, Bucharest, Romania.
authors.forename: Ionel Alexandru
authors.initials: IA
authors.lastname: Checherita
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D050034:Antidiuretic Agents / Q000008:administration & dosage; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010147:Pain Measurement; D011446:Prospective Studies; D056844:Renal Colic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D050034:Antidiuretic Agents; D003894:Deamino Arginine Vasopressin
keywords: Desmopressin; Lithiasis; Renal colic; Sublingual