DESCRIPTION
Desmopressin (trade names: DDAVP, Stimate, Minirin) is a synthetic replacement for vasopressin, the hormone that reduces urine production. It may be taken nasally, intravenously, or as a tablet.
CLASSIFICATION
Desmopressin (1-desamino-8-D-arginine vasopressin) is a modified form of the normal human hormone arginine vasopressin, a peptide containing nine amino acids.
Compared to vasopressin, desmopressin's first amino acid has been deaminated, and the arginine at the eighth position is in the dextro rather than the levo form.
INDICATIONS
- Bedwetting. It is usually in the form of Desmopressin acetate (DAVP). The patients were using desmopressin when they developed Hyponatremia, an imbalance of the body's sodium levels. FDA regulators said that desmopressin tablets could still be considered safe for bedwetting treatment, as long as the patient was otherwise healthy. Patient should be very cautious during hot weather or following strenuous exercise that may make them thirsty. If sodium levels become too low (hyponatremia) - either as a result of increased water take-up or reduced salt levels - a person may have seizures and, in extreme cases, may die.
- Coagulation disorders. Desmopressin can be used to treat mild hemophilia A (factor VIII deficiency), thrombocytopenia and Von Willebrand disease, especially for a surgical prophylaxis. It is not effective in the treatment of hemophilia B (factor IX deficiency) or severe hemophilia A. DDAVP has many different action mechanisms. activation of the endothelial vasopressin
**It stimulates the release of VWF from endothelial cell Weibel-Palade bodies through its agonist effect on vasopressin V2 receptors and c-AMP-mediated signaling. Evidence shows that response to DDAVP diminishes with repeated doses, probably due to depletion of the VWF storage compartment.
The use of desmopressin in mild hemophilia A (2010 Oct)
**F VIII levels also increase, after administration of DDAVP. Although the F VIII storage and the compartment and the mechanism of release by DDAVP have not been fully elucidate to date.
** DDAVP induced the release of tissue plasminogen activator (tPA). However the secreted tPA is rapidly inactivated by plasminogen activator inhibitor (PAI-1) and does not appear to promote fibrinolysis or bleeding after DDAVP treatment.
- Diabetes insipidus. Desmopressin is used in the treatment of central diabetes insipidus (DI), to replace endogenous ADH that is missing in the central nervous system type of this disorder (decreased production of ADH from hypothalamus). It is also used in the diagnostic workup for diabetes insipidus, in order to distinguish central from nephrogenic DI.
SIDE EFFECTS
- headaches
- facial flushing
- nausea
- hyponatremia (due to water retention)
- Transient hypotension or hypertension
