Hormones desmopressin

Other examples of drugs incorporated in nano-emulsions for oral administration are the cephalosporin cefpodoxime proxetil [128] and the hormone desmopressin acetate [129]. 

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). 

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. 

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... 

Desmopressin. Desmopressin is an analogue to the endogenous antidiuretic peptide hormone Vasopressin in which the modifications of the N-terminous amino acid and the replacement of the L-Arg for a D-Arg in position 8, significantly increases its biological stability. In this investigation, the half-life of dDAVP in the rabbit after intravenous administration was determined to be approximately 45 minutes. 

Antidiuretic hormone analogs desmopressin acetate vasopressin... 

Desmopressin acetate is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin, an antidiuretic hormone affecting renal water conservation. It contains 1.5 mg/mL desmopressin acetate in a pH-adjusted aqueous solution with hydrochloric acid to 4.0 ... 

Carbamazepine increases the release of endogenous antidiuretic hormone and can therefore potentiate the antidiuretic effect of desmopressin. Of 103 children with cranial diabetes insipidus included in a retrospective analysis, 10% became hyponatrcmic (76). The risk of hyponatremia was three-fold higher when desmopressin and carbamazepine were given in combination. 

Chlorpromazine increases the release of endogenous antidiuretic hormone and can therefore potentiate the antidiuretic effect of desmopressin (77). 

In two children with cranial diabetes insipidus, desmopressin requirements fell while they were taking lamotrigine (590). Lamotrigine may act at voltage-sensitive sodium channels and reduce calcium conductance. Both of these mechanisms of action are shared by carbamaze-pine, which can cause hyponatremia secondary to inappropriate secretion of antidiuretic hormone. 

Drugs that are routinely administered intranasally include peptides such as vasopressin and its analog desmopressin, luteinizing hormone-releasing hormone, buserelin, leuprolide, nafarelin,... 

Vasopressin and desmopressin are used in the treatment of pituitary diabetes insipidus. They are discussed in Chapter 37 Hypothalamic Pituitary Hormones. 

Hormones and analogues growth hormone corticotrophin (ACTH) calcitonin desmopressin (DD AVP) lypressin oxytocin buserelin nafarelin progesterone norethisterone 17/1-estradiol testosterone insulin Gonadorelin (Gonadotrophin-releasing hormone GnRH LH-RH)... 

Intranasal Desmopressin is administered intranasally in the treatment of diabetes insipidus salmon calcitonin, a peptide hormone used in the treatment of of osteoporosis, is available as a nasal spray. The abused drug, cocaine, is generally taken by sniffing. 

Desmopressin replacement therapy is the first choice. Thiazide diuretics (and chlortalidone) also have paradoxical antidiuretic effect in diabetes insipidus. That this is not due to sodium depletion is suggested by the fact that the nondiuretic thiazide, diazoxide (see Index), also has this effect. It is probable that changes in the proximal renal tubule result in increased reabsorption and in delivery of less sodium and water to the distal tubule, but the mechanism remains incompletely elucidated. Some cases of the nephrogenic form, which is not helped by antidiuretic hormone, may be benefited by a thiazide. 

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 is treated by replacing the antidiuretic hormone by administering desmopressin acetate (DDAVP), desmopressin (Stimate), lypressin (Diapid), vasopressin (aqueous Pitressin), and vasopressin tannate/oil (Pitressin Tannate). 

Its use with bradykinin and desmopressin (Zubarev et al., 1994), illustrated as a case study below, shows the benefits of MS sequence analysis. The latter peptide, desmopressin ( Minirin , a neurohypophysial hormone analogue), involves a disulphide link and a C-terminal amide, as well as a non-coded amino-acid residue (Mpa = mercaptopropionic acid) and these features can be identified by chemical sequencing methods (Chapter 5) only with considerable effort. 

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