D-arginine

Primary therapy is based on disease severity and type of hemorrhage.7 Most patients with mild to moderate disease and a minor bleeding episode can be treated with l-desamino-8-D-arginine vasopressin [desmopressin acetate (DDAVP)], a synthetic analog of the antidiuretic hormone vasopressin. DDAVP causes release of von Willebrand factor (vWF) and factor VIII from endogenous storage sites. This formulation increases plasma factor VIII levels by three- to fivefold within 30 minutes. The recommended dose is 0.3 mcg/kg intravenously (in 50 mL normal saline infused over 15 to 30 minutes) or subcutaneously or 300 meg intranasally via concentrated nasal spray every 12 hours. Peak effect with intranasal administration occurs 60 to 90 minutes after administration, which is somewhat later than with intravenous administration. Desmopressin infusion may be administered daily for up to 2 to 3 days. Tachyphylaxis, an attenuated response with repeated administration, may occur after several doses.8... 

Nondialytic therapies that may temporarily shorten increased bleeding time include cryoprecipitate, desmopressin (l-deamino-8-D-arginine vasopressin), and estrogens. 

D-Arginine, systematic name, formula, and molecular weight, 2 557t... 

D-Arginine and D-ornithine metabolism D-Alanine metabolism Glutathione metabolism Alkaloid biosynthesis I Alkaloid biosynthesis II Metabolism of Complex Carbohydrates Starch and sucrose metabolism Biosynthesis and degradation of glycoprotein... 

Xln, Y.-E, Zhou, X.-J., Cheng, X., and Wang, Y.-X. (2005). Renal D-amino acid oxidase mediates chiral inversion of N -nitro-D-arginine./. Pharmacol. Exp. Ther 312, 1090-1096. 

This enzyme [EC 5.1.1.9] catalyzes the interconversion of L- and D-arginine. The enzyme requires pyridoxal phosphate as a cofactor. 

Desmopressin Desmopressin, 8-D-arginine vasopressin-l-(3-mercaptopropionic acid) (24.4.6), is a structural analog of vasopressin. It is synthesized by a multi-step synthesis by methods specific to peptide chemistry, and its synthesis will not be examined here [71-74],... 

FFP, fresh frozen plasma DDAVP, l-deamino-8-D-arginine vasopressin. 

Desmopressin f/V-deamino-8-D-arginine vasopressin, dDAVP) is a longer acting analogue of vasopressin. It has very little vasoactive effect but is antidiuretic by an action on vasopressin V2 receptors in the renal tubule and is used to treat central diabetes insipidus and nocturnal enuresis. 

Holmberg L, Nilsson IM, Borge L, Gunnarsson M, Sjorin E. Platelet aggregation induced by l-desamino-8-D-arginine vasopressin (DDAVP) in Type IIB von Willebrand s disease. N Engl J Med 1983 309(14) 816-21. 

Watson AJ, Keogh JA. l-Deamino-8-D-arginine vasopressin as a therapy for the bleeding diathesis of renal failure. Am J Nephrol 1984 4(1) 49-51. 

Kobrinsky NL, Israels ED, Gerrard JM, Cheang MS, Watson CM, Bishop AJ, Schroeder ML. Shortening of bleeding time by l-deamino-8-D-arginine vasopressin in various bleeding disorders. Lancet 1984 l(8387) 1145-8. 

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