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DesmopressinAka: dDAVP

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  1. Indications
    1. Diabetes Insipidus
    2. Control of Hemophilia A related bleeding
    3. Von Willebrand's Disease
    4. Primary Nocturnal Enuresis
  2. Mechanism
    1. Synthetic ADH replacement hormone (anologue of Vasopressin)
    2. Potent antidiuretic
    3. No vasopressor activity
    4. Urine volume decreases by resorbing water at distal renal tubules
  3. Pharmacokinetics
    1. Duration of action: 12 hours
  4. Dosing: Nocturnal Enuresis
    1. General
      1. If effective, may continue for 3-6 months
      2. Maintain dose for 4-6 weeks and then slowly taper off over 6 months
        1. Discontinue slowly (e.g. 10 mcg/month)
        2. Reduces risk of relapse
      3. Consider in combination with Bed-Wetting Alarm or Oxybutynin
    2. Desmopressin Intranasal
      1. Not recommended due to risk of water intoxication
      2. Initial: 5 mcg spray each nostril qhs
      3. Increase as needed up to 20 mcg each nostril qhs
    3. Desmopressin Oral
      1. Initial: 0.2 mg PO qhs
      2. Use lowest effective dose
      3. Increase as needed to 0.6 mg at bedtime
  5. Dosing: General
    1. Nasal Spray: 5-20 mcg daily to twice daily
      1. Intranasal 5 mcg equivalent to 0.1 mg PO
    2. Oral Tablet: 0.1 mg PO daily to twice daily
  6. Adverse Effects
    1. Nasal irritation or Epistaxis with nasal spray
    2. Behavior changes
      1. Aggressive behavior
      2. Nightmares
    3. Nocturia
      1. Administer at night to reduce nocturia
    4. Water retention and Hypernatremia (water intoxication)
  7. Efficacy: Nocturnal Enuresis
    1. Most effective in over age 8-9 years (60-70% respond)
    2. Also more effective if only a few wet nights and normal bladder capacity
    3. High relapse rate (>80%); Reduced if slowly tapered - see doing above
  8. Disadvantages
    1. Very Expensive
  9. References
    1. Tullus (1999) Acta Paediatr 88:1274
    2. Kruse (2001) BJU Int 88:572
    3. Robson (2007) J Urol 178:24

Deamino Arginine Vasopressin (C0011701)

Definition (NCI)A synthetic octapeptide, and an analogue of human hormone arginine vasopressin with antidiuretic and coagulant activities. Desmopressin binds to V2 receptors in renal collecting ducts which leads to exocytosis of von Willebrand factor (VWF) and tissue plasminogen activator (t-PA) from Weibel-Palade bodies, thereby increasing water resorption. This agent also increases nitric oxide (NO) production via activation of endothelial NO synthase, thereby induces afferent arteriolar vasodilation. Furthermore, desmopressin stimulates the release of factor VIII from endothelial cells mediated through V1a receptor, thereby promotes blood coagulation.
Definition (MSH)A synthetic analog of the pituitary hormone, ARGININE VASOPRESSIN. Its action is mediated by the VASOPRESSIN receptor V2. It has prolonged antidiuretic activity, but little pressor effects. It also modulates levels of circulating FACTOR VIII and VON WILLEBRAND FACTOR.
ConceptsAmino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) , Hormone (T125)
MSHD003894
English1-Deamino-8-D-arginine Vasopressin, 1-Desamino-8-arginine Vasopressin, Deamino Arginine Vasopressin, Desmopressin, Desmopressin preparation, Desmopressin product
Spanishdesmopresina, preparado con desmopresina, preparado de desmopresina
Parent ConceptsArgipressin (C0003779), Recombinant Vasopressin (C1527128), Posterior Pituitary Hormones (C0032017), Vasopressin (USP) (C1705480), Hemostatic Agents (C0019120), Vasopressin and derivatives (C1627343), Pituitary Hormonal Agents (C1579308)
SourcesMSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


DDAVP (C0701195)

ConceptsAmino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) , Hormone (T125)
MSHD003894
EnglishAventis Behring Brand 1 of Desmopressin Acetate, Aventis Brand of Desmopressin Acetate, DDAVP, Desmopressine Ferring, Desmospray, Desmotabs, Ferring Brand of Desmopressin Acetate, IQFA Brand of Desmopressin Acetate, Minirin, Minurin, Octim, Octostim
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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