DDAVP


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DDAVP

 
trademark for preparations of desmopressin acetate, a synthetic analogue of vasopressin used to treat central diabetes insipidus, increased urination caused by trauma or surgery in the pituitary region, primary nocturnal enuresis, hemophilia A, and von Willebrand's disease.

desmopressin acetate (1-deamino-8-D-arginine vasopressin)

Apo-Desmopressin (CA), DDAVP, DesmoMelt (UK), Desmospray (UK), Stimate

Pharmacologic class: Posterior pituitary hormone

Therapeutic class: Antidiuretic hormone

Pregnancy risk category B

Action

Enhances water reabsorption by increasing permeability of renal collecting ducts to adenosine monophosphate and water, thereby reducing urinary output and increasing urine osmolality. Also increases factor VIII (antihemophilic factor) activity.

Availability

Injection: 4 mcg/ml in single-dose 1-ml ampules and multidose 10-ml vials

Intranasal solution: 0.1 mg/ml, 1.5 mg/ml

Intranasal spray (DDAVP): 0.1 mg/ml (10 mcg/spray) in 5-ml spray pump bottle

Tablets: 0.1 mg, 0.2 mg

Indications and dosages

Diabetes insipidus

Adults and children older than age 12: 0.05 mg P.O. b.i.d.; adjust dosage based on patient response. Or 0.1 to 0.4 ml (10 to 40 mcg) daily intranasally as a single dose or in two or three divided doses. Or 0.5 ml (2 mcg) to 1 ml (4 mcg) daily I.V. or subcutaneously, usually in two divided doses.

Children ages 3 months to 12 years: 0.05 to 0.3 ml/day intranasally in one or two divided doses

Hemophilia A; von Willebrand's disease type I

Adults and children: 0.3 mcg/kg I.V.; may repeat dose if needed. Or 300 mcg of intranasal solution containing 1.5 mcg/ml; for patients weighing less than 50 kg (110 lb), total dosage of 150 mcg (one spray of solution containing 1.5 mg/ml into a single nostril) is usually sufficient. If needed to maintain hemostasis during surgery, give intranasal dose 2 hours before surgery or give I.V. dose 30 minutes before surgery.

Off-label uses

• Chronic autonomic failure (such as nocturnal polyuria, overnight weight loss, morning orthostatic hypotension)

Contraindications

• Hypersensitivity to drug
• Moderate to severe renal impairment
• Hemophilia A with factor VIII levels less than or equal to 5%
• Von Willebrand's disease type IIB
• Impaired level of consciousness (intranasal form)

Precautions

Use cautiously in:
• coronary artery disease, hypertensive cardiovascular disease, fluid and electrolyte imbalances
• breastfeeding patients.

Administration

• Adjust morning and evening dosages as appropriate to minimize frequent urination and risk of water intoxication.
• Give I.V. dose (diluted in normal saline solution) by infusion over 15 to 30 minutes.
• Monitor pulse and blood pressure throughout I.V. infusion

When giving to child with diabetes insipidus, carefully restrict fluid intake to prevent hyponatremia and water intoxication.

Adverse reactions

CNS: headache, dizziness, insomnia

CV: slight blood pressure increase, chest pain, palpitations

EENT: rhinitis, epistaxis, sore throat

GI: nausea, abdominal pain

GU: vulvar pain

Respiratory: cough

Other: local erythema, flushing, swelling or burning after injection

Interactions

Drug-drug.Carbamazepine, chlorpropamide, pressor drugs: potentiation of desmopressin effects

Patient monitoring

• Monitor urine volume and specific gravity, plasma and urine osmolality, and electrolyte levels in patients with diabetes insipidus.
• Monitor factor VIII antigen levels, activated partial thromboplastin time, and bleeding time in patients with hemophilia.

When giving to child with diabetes insipidus, carefully monitor fluid intake and output.

Patient teaching

• Instruct patient to take drug exactly as prescribed and not to interchange strengths or delivery systems.
• Teach patient how to use prescribed delivery system if taking drug by other than oral route.
• Instruct patient with diabetes insipidus to avoid overhydration and to weigh himself daily. Tell him to report weight gain or swelling of arms or legs.
• If patient is using nasal spray, teach him to inspect nasal membranes regularly and to report increased nasal congestion or swelling.
• Caution elderly patient not to increase fluid intake beyond that sufficient to satisfy thirst.
• Instruct patient to report headache, respiratory difficulty, nausea, or abdominal pain to prescriber.
• As appropriate, review all significant adverse reactions and interactions, especially those related to the drugs mentioned above.

DDAVP

(dē′dē′ā′vē′pē′)
A trademark for the drug desmopressin acetate.

DDAVP

a trademark for an antidiuretic (desmopressin acetate).

DDAVP®

1-deamino, 8-DD-arginine vasopressin, desmopressin acetate Endocrinology A long-acting antidiuretic vasopressin analog given intranasally, to manage diabetes insipidus and primary nocturnal enuresis. See ADH.

DDAVP

Abbreviation for desmopressin acetate.

DDAVP

Des-amino-D-arginine vasopressin or DESMOPRESSIN. A brand name for DESMOPRESSIN.

DDAVP

Desmopressin acetate, a drug used to regulate urine production.
Mentioned in: Bed-Wetting

DDAVP

References in periodicals archive ?
Compared with the control group, the blood loss at 6 h after surgery was significantly reduced in DDAVP group.
4] Nonstandard abbreviations: vWF, von Willebrand factor; vWD, von Wille brand disease; DDAVP, 1-deamino-[8-D-arginine]-vasopressin; vWF:Ag, vWF antigen; vWF:RCof, ristocetin cofactor activity; vWF:CB, collagen-binding assay; FCS, fluorescence correlation spectroscopy; TRITC, tetramethyl-rhodamine isothiocyanate.
Absortion of intragastrically administered DDAVP in conscious dogs.
For the remaining course of her hospitalisation, the DDAVP dose was titrated based on the serum sodium and urinary output and she continued to require electrolyte repletion.
DDAVP is useful for patients with type 1 disease where there is still a significant circulating level of functional protein; it may occasionally be of benefit in type 2A, and is theoretically contraindicated in type 2B (where it may worsen the thrombocytopenia).
DDAVP decreases the amount of nightly urine and is sometimes helpful as a short term solution for overnights at friend's houses or camping trips.
DDAVP stimulates release of stored factor VIII and von Willebrand factor from the endothelium of blood vessels (Revel-Vilk et al.
The effects of DDAVP are not long-lasting, and children often relapse when the drug is stopped.
The treatment of haemophilia, including prophylaxis, constant infusion and DDAVP.
Where DDAVP and alarms are costly to families or unavailable, and the history and physical examination negative for complicating factors, there is nothing to lose by trying behavioural modification as a first-line nursing intervention.
DDAVP reduces nighttime urine production and can help on overnight sleepovers or campouts.