Desmopressine

In central diabetes insipidus a hypophysial malfunction, caused by different diseases as well as head injuries, neurosurgery, or genetic disorders, leads to AVP hyposecretion. This type of diabetes insipidus can successfully be treated by the exogenous administration of AVP or AVP analogues (e.g. desmopressin). 

Syndrome of inappropriate antidiuretic hormone is defined by water retention, dilutional hyponatraemia and decreased volume of highly concentrated urine. There are several causes which can result in SIADH, neoplasms ectopic secreting AVP, ectopic release of AVP by various diseases or drugs, exogenous administration of AVP, desmopressin, lysipressin or large doses of OT (iatrogenic SLADH). 

OPC-51803 is a highly selective V2R agonist and may prove useful for the treatment of CDI, urinary incontinence, enuresis and pollakiuria. It has a much higher bioavailability after oral application than desmopressin. 

Vasopressin (Rtressin Synthetic) and its derivatives, namely lypressin (Diapid) and desmopressin (DDAVP), regulate the reabsorption of water by the kidneys. Vasopressin is secreted by the pituitary when body fluids must be conserved. An example of this mechanism may be seen when an individual has severe vomiting and diarrhea with little or no fluid intake. When this and similar conditions are present, die posterior pituitary releases the hormone vasopressin, water in die kidneys is reabsorbed into die blood (ie, conserved), and die urine becomes concentrated. Vasopressin exhibits its greatest activity on die renal tubular epithelium, where it promotes water resoqition and smooth muscle contraction throughout die vascular bed. Vasopressin has some vasopressor activity. 

Desmopressin may be given orally, intranasally, SC, or IV. The oral dose must be determined for each individual patient and adjusted according to the patient s response to therapy. When the drug is administered nasally, a nasal tube is used for administration. The nasal tube delivery system comes with a flexible calibrated plastic tube called a rhinyle. The solution is drawn into the rhinyle. One end is inserted into the nostril and the patient (if condition allows) blows the other end to deposit solution deep into the nasal cavity. A nasal spray pump may also be used. Most adults require 0.2 mL daily in two divided doses to control diabetes insipidus. The drug may also be administered via the SC route or direct IV injection. 

Educating the Patient and Family If lypressin or desmopressin is to be used in the form of a nasal spray or is to be instilled intranasally usingthe nasal tube delivery system, the nurse demonstrates the technique of instillation (see Fhtient and Family Teaching Checklist Self-Adnrinistering Nasal Vasopressin). The nurse includes illustrated patient instructions with the drug and reviews them with the patient. If possible, the nurse lias the patient demonstrate the technique of administration. The nurse should discuss the need to take the drug only as directed by the primary health care provider. The patient should not increase the dosage (ie, the number or frequency of sprays) unless advised to do so by the primary health care provider. 

DDAVP (Ferring) Minirin (Ferring) Desmopressin (Kyowa Hakko)... 

H4N2 302-01-2) see Acetazolaraide Allopurinol Brotizolam Carbidopa Cibenzoline Desmopressin Estazolam Etizolam Guanadrel Isoniazid Itraconazole Mitopodozide Niftiroxazide Nifurtimox Nitrofurantoin Phenelzine Primaquine Ziprasidone hydrochloride hydrazine-1,2-bis(thiocarbaxamide)... 

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