Десмопрессин: Қолданылуы, әсері және ескертулер

Medication

Desmopressin, sold under the trade name DDAVP among others, is a medication used to treat diabetes insipidus, bedwetting, hemophilia A, von Willebrand disease, and high blood urea levels. Common side effects include headaches, diarrhea, and low blood sodium. and reduction of urine production. It is available as a generic medication.

In 2017, the FDA approved Desmopressin has some benefit for adults who have problems with nocturia (having a need to wake up at night for urination).

Desmopressin (DDAVP) is usually the first line treatment for mild to moderate type 1 von Willebrand disease. However, US drug regulators have said that desmopressin tablets can still be considered safe for treatment of nocturnal enuresis in children as long as the person is otherwise healthy. Patients must stop taking desmopressin if they develop severe vomiting and diarrhea, fever, the flu, or severe cold. Patients should also be very cautious about taking desmopressin during hot weather conditions or following strenuous exercise, as these conditions can place stress on the body's electrolyte and water balance. A body needs to maintain a balance of water and sodium. 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.

Desmopressin works by limiting the amount of water that is eliminated in the urine; that is, it is an antidiuretic. It works at the level of the renal collecting duct by binding to V2 receptors, which signal for the translocation of aquaporin channels via cytosolic vesicles to the apical membrane of the collecting duct. The presence of these aquaporin channels in the distal nephron causes increasing water reabsorption from the urine, which becomes passively re distributed from the nephron to systemic circulation by way of basolateral membrane channels. Desmopressin also stimulates release of von Willebrand factor from endothelial cells by acting on the V2 receptor. It also increases endogenous levels of factor VIII, making it useful in the treatment of hemophilia A.

Desmopressin is degraded more slowly than recombinant vasopressin, and requires less frequent administration. In addition, it has little effect on blood pressure, while vasopressin may cause arterial hypertension. Vasopressin stimulates the release of ACTH, which indirectly increases responsiveness of alpha 1 receptor in blood vessel smooth muscle, increasing vessel tone and blood pressure. and therefore does not directly raise blood pressure, however, one study showed that it stimulates ACTH release in over 50% of healthy subjects. Additionally, desmopressin is able to enhance ACTH and cortisol release in normal subjects following oCRH administration, but not in patients with anorexia nervosa.

Desmopressin (1 deamino 8 D arginine vasopressin) is a synthetic form of the normal human hormone arginine vasopressin (the antidiuretic hormone, or ADH), 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 (see stereochemistry).