Diabetes insipidus antidiuretic hormone agonists

DIABETES INSIPIDUS TREATMENT involves the administration of drugs to counteract the under-production of antidiuretic hormone (ADH vasopressin) by the pituitary gland, which is a characteristic of diabetes insipidus. ADH itself (arginine vasopressin or lysine vasopressin) can be used, as can the analogues desmopressin and terlipressin. These are all (V subtype) VASOPRESSIN RECEPTOR AGONISTS. These agents are discussed... 

B. Vasopressin (Antidiuretic Hormone, ADH) Vasopressin is synthesized in the supraoptic nuclei of the hypothalamus and released from the posterior pituitary. As discussed in Chapter 15, vasopressin acts on V2 receptors and increases the synthesis or insertion of water channels by a cAMP-dependent mechanism, resulting in an increase in water permeability in the collecting tubules of the kidney. The increased water permeability permits water reabsorption into the hypertonic renal papilla, thus causing the antidiuretic effect. Vasopressin also causes smooth muscle contraction (a V, effect). Desmopresan, a selective agonist of V2 receptors, is used in the treatment of pituitary diabetes insipidus. 

Desmopressin Antidiuretic hormone analog Pituitary diabetes insipidus A Vj receptor agonist longer-acting than vasopressin (ADH)... 

Either remifentanil or propofol could have been responsible in this case. Remi-fentanil is a pure p opioid receptor agonist, which inhibits vasopressin release from the posterior pituitary however, this patient had previously had a hypophysectomy. Propofol reversibly inhibits the action of antidiuretic hormone in rat hypothalamus, and this could have formed the basis of transient diabetes insipidus. 

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