antidiuretic drugs

8/13/2019 Antidiuretic Drugs

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Prepared by Navjot Brar, lecturer, Mai Bhago College of Nursing, Tarn-Taran

Antidiuretic drugs:

Classification:1. ADH (vasopressin)2. Thiazide diuretics3. Miscellaneous

Chlorpropamide Carbamazepine

Vasopressin:Vasopressin is a man-made form of a hormone called "anti-diuretic hormone" that is

normally secreted by the pituitary gland. In the body, vasopressin acts on the kidneys and blood

vessels.

Vasopressin helps prevent the loss of water from the body by reducing urine output and helping the

kidneys reabsorb water in the body. Vasopressin also raises blood pressure by constricting (narrowing)

blood vessels.

Mechanism of action:

It enhances water reabsorption from the collecting ducts, it activates the V2 receptors on the cell

membrane thereby in creases the water permeability of these cells.

It also causes vasoconstriction and immediately raises the blood pressure mediated by V1 receptors. It

also acts on other smooth muscles and increases peristalsis movements in the gut and contracts the

uterus.

Indications:

Vasopressin is used to treat diabetes insipidus, which is caused by a lack of this naturally occurringpituitary hormone in the body. Vasopressin is also used to treat or prevent certain conditions of the

stomach after surgery or during abdominal x-rays.

`Night time bed wetting Hemophilia A Dehydration von Willebrand's Disease Demonstration of an adequate improvement in coagulation profile after administration is

recommended prior to any surgical procedures. Preoperative doses may be given 2 hours prior to

the scheduled procedure.

Ventricular fibrillation Other cardiac arrhythmias Gastrointestinal Hemorrhage


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Contraindications:

chronic kidney condition such as Bright's disease. Asthma kidney disease congestive heart failure hardened arteries migraine headaches seizures coronary artery disease, hardening of the arteries; circulation problems;

Usual Adult Dose for Diabetes Insipidus

Initial dose: 0.05 mg orally twice a day or

1 to 2 mcg IV twice a day or 1 to 2 mcg subcutaneously twice a day or 5 to 40 mcg spray intranasally twice a day or

o to 0.4 mL via rhinal tube intranasally twice a day.Interactions:Common medications checked in combination with desmopressin

Abilify (aripiprazole)

Abilify (aripiprazole)

Celexa (citalopram)

Celexa (citalopram)

Cymbalta (duloxetine)

Cymbalta (duloxetine)

Lexapro (escitalopram)

Lexapro (escitalopram)

Nexium (esomeprazole)

Nexium (esomeprazole)

Seroquel (quetiapine)

Seroquel (quetiapine)

Singulair (montelukast)

Singulair (montelukast)

Synthroid (levothyroxine)

Synthroid (levothyroxine)

Vitamin C (ascorbic acid)

Vitamin C (ascorbic acid)

Vitamin D3 (cholecalciferol)

Vitamin D3

Carbamazepine, chlorpromazine, lamotrigine, narcotic analgesics (eg, codeine), nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), oxybutynin, selective serotonin reuptake inhibitors

(SSRIs) (eg, fluoxetine), or tricyclic antidepressants (eg, imipramine) because the risk of fluid

overload with low blood sodium levels may be increased.


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an antidepressant such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine(Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Janimine, Tofranil),

nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil

Side effects:

Rare Chillsconfusion

convulsions (seizures)

decreased urination

drowsiness

fast heartbeat

fever

headache (continuing)

shortness of breath, tightness in chest, trouble in

breathing, or wheezing

skin rash, hives, or itchingweight gain (rapid)

"blanching" of skin (such as pale spots when you

press on the skin).

"pounding'' in head

Less common or rare Abdominal or stomachcramps

flushing or redness of skin

nausea

painin the vulva (genital area outside of the

vagina)

With intranasal (through the nose) use Cough

nosebleed

runny or stuffy nose

sneezing

sore throatWith intravenous use Pain, redness, or swelling at

place of injection

trembling white-colored area around the mouth

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of

the mouth, face, lips, or tongue); confusion; fainting; loss of appetite; mental or mood changes (eg,

agitation, irritability); muscle weakness, spasms, or cramps; nausea; personality changes; seizures;swelling; unusual headache or restlessness; unusual tiredness or sluggishness; unusual weight gain;

vomiting.

Important safety information:

Desmopressin may cause dizziness. These effects may be worse if you take it with alcohol or certain

medicines. Use desmopressin with caution. Do not drive or perform other possibly unsafe tasks until

you know how you react to it.

Follow the fluid intake instructions given to you by your health care provider very carefully. Serious

side effects may occur if you drink too much liquid while taking desmopressin.

Check with your doctor if you experience infection, fever, vomiting, or diarrhea. Tell your doctor if

you will be exposed to very hot weather, will be physically active, or will be increasing your water

intake for any reason. The risk of low blood sodium levels may be increased.


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Do NOT take more than the recommended dose or use for longer than prescribed without checking

with your doctor.

Tell your doctor or dentist that you take desmopressin before you receive any medical or dental care,

emergency care, or surgery.

Lab tests, including urine volume or blood electrolyte levels, may be performed while you use

desmopressin. These tests may be used to monitor your condition or check for side effects. Be sure to

keep all doctor and lab appointments.

Use desmopressin with caution in the ELDERLY and in CHILDREN; they may be more sensitive to

its effects, especially water overload. Signs of water overload may include severe or persistent nausea

or headache, vomiting, or unusual weight gain.

Desmopressin should be used with extreme caution in CHILDREN younger than 6 years old if used

for nighttime bedwetting; effectiveness for bedwetting in these children has not been confirmed.

PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will needto discuss the benefits and risks of using desmopressin while you are pregnant. It is not known if

desmopressin is found in breast milk. If you are or will be breast-feeding while you are using

desmopressin, check with your doctor. Discuss any possible risks to your baby.

"blanching" of your skin (such as pale spots when you press on the skin). Drinking 1 or 2 glasses ofwater each time you receive an injection may help ease these side effects.

Some medical conditions may interact with desmopressin. Tell your doctor or pharmacist if you have

any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding

if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary

supplement

if you have allergies to medicines, foods, or other substances

if you have severe drowsiness

if you have a history of kidney problems, heart problems (eg, heart blood vessel problems), or high

blood pressure

if you have cystic fibrosis, dehydration, fever, severe infection, vomiting or diarrhea, swelling or fluid

retention, or abnormal blood electrolyte levels

if you are exposed to very hot weather, are physically active, or drink a lot of water

if you have recently had surgery in the head area

antidiuretic drugs

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