Desmopressin (wikipedia)


vasopressinDesmopressin (trade names: DDAVP, Stimate, Minirin) is a synthetic replacement for vasopressin, the hormone that reduces urine production during sleep. It may be taken nasally, intravenously, or as a pill. Doctors prescribe Desmopressin most frequently for treatment of diabetes insipidus or bedwetting.

In December 2007, US drug regulators banned using desmopressin nasal sprays for treating bedwetting, but said that desmopressin pills are still a safe bedwetting treatment for otherwise healthy patients. The regulators reviewed the drug after two patients using desmopressin nasal sprays died from hyponatremia, an imbalance of sodium levels in the body
Bedwetting
Doctors prescribe desmopressin frequently for treatment of bedwetting. It is usually in the form of Desmopressin acetate, DDAVP. Patients taking DDAVP are 4.5 times more likely to stay dry than those taking a placebo. [2] The drug replaces the antidiuretic hormone for a single night with no cumulative effect.

US drug regulators banned treating bedwetting with desmopressin nasal sprays after two patients died and 59 other patients suffered seizures. The patients were using desmopressin when they developed Hyponatremia, an imbalance of the body’s sodium levels. [3]

FDA regulators said that desmopressin pills could still be considered safe for bedwetting treatment, as long as the patient was otherwise healthy. Patients must stop taking desmopressin if they become sick and have severe vomiting and diarrhoea, fever, the flu, or severe cold. They should also be very cautious during hot weather or following strenuous exercise that may make them thirsty.

This is because desmopressin works by limiting the amount of water that is eliminated in the urine. A healthy body needs to maintain a balance of water and salt (sodium). If sodium levels become too low (hyponatremia) – either as a result or increased water take-up or reduced salt levels – a person may have seizures and, in extreme cases, may die. [4]

Coagulation disorders
Desmopressin can be used to promote the release of von Willebrand factor and factor VIII in patients with coagulation disorders such as type I von Willebrand disease, mild hemophilia A (factor VIII deficiency), and thrombocytopenia. It can be used with uremic induced anemia due to platelet dysfunction. It is not effective in the treatment of hemophilia B (factor IX deficiency) or severe hemophilia A.
Diabetes insipidus
Desmopressin is used in the treatment of central diabetes insipidus (DI), to replace endogenous ADH that is missing in this disorder. It is also used in the diagnostic workup for diabetes insipidus, in order to distinguish central DI from other forms of DI

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