Desmopressin

Desmopressin is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin (ADH), an antidiuretic hormone affecting renal water conservation. It is primarily used in the management of Central Diabetes Insipidus, for the treatment of Nocturnal Enuresis (bedwetting), and in the treatment of von Willebrand's Disease and mild Hemophilia A. Desmopressin works by limiting the amount of water that is eliminated in the urine.

Medical Uses

Desmopressin is used in the treatment of:

• Central Diabetes Insipidus, where it reduces the volume of urine produced by the kidneys.
• Nocturnal Enuresis (bedwetting), where it decreases nighttime urine production.
• von Willebrand's Disease and mild Hemophilia A, where it increases the levels of von Willebrand factor and factor VIII, respectively, thereby aiding in the clotting process.

Mechanism of Action

Desmopressin acts on the V2 receptors in the renal collecting ducts, leading to the translocation of aquaporin-2 water channels to the apical membrane of the cells and thereby increasing water reabsorption. In patients with bleeding disorders, desmopressin stimulates the release of von Willebrand factor and factor VIII stored in the endothelium, which helps in controlling bleeding.

Administration

Desmopressin can be administered intranasally, orally, or by subcutaneous or intravenous injection. The mode of administration depends on the condition being treated and the patient's needs.

Side Effects

Common side effects of desmopressin include headache, facial flushing, nausea, and abdominal cramps. Severe side effects may include hyponatremia (low sodium levels), which can lead to seizures if not properly managed.

Contraindications

Desmopressin is contraindicated in individuals with:

• Hyponatremia or a history of hyponatremia.
• Severe renal impairment.
• Uncontrolled hypertension.
• Known hypersensitivity to desmopressin or any of its components.

Pharmacokinetics

Desmopressin has a half-life of approximately 1.5 to 2.5 hours, with variations depending on the route of administration. Its effects on the kidneys can last up to 8 hours, while its effects on clotting factors can last up to 24 hours.

See Also

• Antidiuretic Hormone
• Vasopressin Receptor
• Aquaporin
• Urinary System

References

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  Desmopressin chemical structure

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  Desmopressin ball-and-stick model