Diabetes insipidus treatment

Unlabeled Uses Prophylaxis and treatment of central diabetes insipidus, treatment of hemophilia A, von Willebrand s disease... 

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... 

Diabetes insipidus, prevention and treatment of postoperative abdominal distension, to dispel gas interfering with abdominal x-ray examination... 

Vasopressin and its derivatives are used in die treatment of diabetes insipidus, a disease resulting from die failure of the pituitary to secrete vasopressin or from surgical removal of die pituitary. Diabetes insipidus is characterized by marked increase in urination (as much as 10 L in 24 hours) and excessive tiiirst by inadequate secretion of die antidiuretic hormone or vasopressin. Treatment with vasopressin therapy replaces die hormone in the body and restores normal urination and thirst Vasopressin may also be used for die prevention and treatment of postoperative abdominal distention and to dispel gas interfering with abdominal roentgenography. 

The patient verbalizes an understanding of the treatment modalities and the importance of continued follow-up care (diabetes insipidus). 

The answer is c. (Katzung, p 493.) Lithium treatment frequently causes polyuria and polydipsia. The collecting tubule of the kidney loses the capacity to conserve water via anti diuretic hormone. This results in significant free-water clearance, which is referred to as nephrogenic diabetes insipidus. 

The answer is a. (Katzung, pp 255-256.) Thiazide diuretics can be used in the treatment of nephrogenic diabetes insipidus. Its other uses include the treatment of hypertension, CHF, and nephrolithiasis due to idiopathic hypercalcuria. 

The long-term toxic effects of lithium, such as nephrogenic diabetes insipidus, which has been calculated to occur in up to 5% of patients, and the rare possibility of lithium combined with neuroleptics being neurotoxic, has stimulated the research for other drug treatments. However, apart from the neuroleptics, these drugs have not been studied as extensively in the treatment of acute mania, but are worthy of consideration because of their reduced side effects. 

Carbamazepine stimulates antidiuretic hormone activity and has been used for the treatment of neurohypophyseal diabetes insipidus. Carbamazepine induces microsomal enzymes and its metabolism is subject to auto-induction. Frequently occurring adverse effects are sedation, dry mouth, dizziness and gastrointestinal disturbances. Photosensitivity reactions, urticaria and Stevens-Johnson syndrome have been described. The elderly are more prone to mental confusion, cardiac abnormalities and problems due to inappropriate ADH secretion. 

Because it is stable, desmopressin is preferred for treatments especially if pressor effects are not desired. The primary indication for therapy is central diabetes insipidus, a disorder that results when ADH secretion is reduced and that is characterized by polydipsia, polyuria, and dehydration. Desmopressin is also used to reduce primary nocturnal enuresis, or bedwetting, in children. It is useful in people with mild hemophilia A or with some types of von Willebrand s disease, in which von Willebrand s factor is present at low levels. In these cases, desmopressin is given when excessive bleeding occurs or before surgery to help reduce bleeding indirectly by increasing the amounts of coagulation factors. 

Unlabeled Uses Treatment of alcohol withdrawal, diabetes insipidus, neurogenic pain, psychotic disorders... 

Unlabeled Uses Treatment of diabetes insipidus, prevention of calcium-containing renal stones... 

Both drugs are used in conjunction with other diuretics like thiazide or loop diuretics to augment natriuresis and reduce loss of potassium. Triamterene may be used in the treatment of congestive heart failure, cirrhosis and the edema caused by secondary hyperaldosteronism. Amiloride is also useful in lithium induced diabetes insipidus. 

Antidiuretic agents reduce urine volume and are used in the treatment of diabetes insipidus. They are classified as in table 4.7.2. 

The antidiuretic hormone is an octapeptide released from the posterior lobe of pituitary gland. It is used in the treatment of diabetes insipidus. ADH reduces the total urine volume and absence of this hormone cause diabetes insipidus. ADH acts on collecting duct cells to increase their water permeability. It acts on V2 receptors in collecting duct and regulate their water permeability through cAMP production. 

ADH in larger dose increases the blood pressure by direct stimulation of vascular smooth muscle. It also stimulates the smooth muscle of gastrointestinal tract and increase the peristalsis. It is inactive orally because it is destroyed by trypsin. It can be administered by any parenteral route or by nasal spray. Vasopressin is indicated in diabetes insipidus and in treatment of postoperative abdominal varices. 

It is indicated in the treatment of maturity onset non ketotic diabetes mellitus unresponsive to diet and neurogenic diabetes insipidus. 

Antidiuretic hormone (ADH) Bovine posterior pituitaries Treatment of diabetes insipidus... 

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