Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Hydrochlorothiazide, HCTZ; Methyldopa: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 0.2 to 0.6 mg orally once daily before bedtime. DDAVP Injection (desmopressin acetate) is a man-made form of a hormone that occurs naturally in the pituitary gland used to treat hemophilia A or von Willebrand's disease Type I, and is also used to treat central cranial diabetes insipidus, and increased thirst and urination caused by head surgery or head trauma. To prime, press down 4 times. ! Also remove sticky note when IV to po is addressed. once BP controlled with IV therapy switch to PO therapy at 200 mg. then 200-400mg 6-12 hours later titrating to effect. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Initially, 0.2 mg PO once daily at bedtime. However, the amount of orally administered drug reduced for its i.p., i.m., s.c., or i.v. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. peak plasma concentration (Cmax) was 4 (+/- 3.85) pg/mL for the 0.83 mcg dose and 9.11 (+/- 6.90) pg/mL for the 1.66 mcg dose. doi: 10.31744/einstein_journal/2023RC0124. The recommended maintenance dose is 10 mcg/day to 40 mcg/day intranasally (0.1 mL/day to 0.4 mL/day) in 1 to 3 divided doses. In a male subject with mild Von Willebrand (vW) disease, intravenous infusion of DDAVP 2 hours after administration of oral tolvaptan did not produce the expected increases in vW Factor Antigen or Factor VIII activity. Bumetanide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Vincristine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Bioavailability and pharmacokinetics of desmopressin in elderly men. Severe allergic reactions, including anaphylaxis, have been reported with intravenous and intranasal desmopressin. Desmopressin is not indicated for persons with severe classic vWD (type 1), for the treatment of hemophilia B, or in persons with factor VIII antibodies. 1 0 obj According to the Beers Criteria, desmopressin is considered a potentially inappropriate medication (PIM) in geriatric adults and avoidance is recommended for treating nocturia or nocturnal polyuria because there is a high risk of hyponatremia and safer alternatives are available. It is not known whether antibodies to desmopressin injection are produced after repeated injections. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Which lab value should prompt the nurse to question a medication dosage increase? The 0.83 mcg dose did not meet all prespecified efficacy endpoints in clinical trials, but may have a lower risk of hyponatremia. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Candesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. xTMk1?DFh!PiHhmz(=lk;p"v< Fobt7t?@IFT];XaYV={~w ^JLAIIG\G\m$XJe@xH8!ZDhrN*'VH4'J.cq 'A%;v}q+i+&L 44qDxR)o3 If there is no response, the medication will be stopped. Results: No adverse developmental outcomes were observed in animal reproduction studies with administration of desmopressin during organogenesis to pregnant rats and rabbits at doses approximately less than 1 and 38 times, respectively, the maximum recommended human dose based on body surface area (mg/m2). 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. A woman who took both desmopressin and ibuprofen was found in a comatose state. A woman who took both desmopressin and ibuprofen was found in a comatose state. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Metoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Guardrail Drug Requires documentation of two (2) RN's for double-checking. PMC BJU Int. documenting the conversion using the "IV to PO conversion" category. Do not transfer any remaining solution to another bottle. A woman who took both desmopressin and ibuprofen was found in a comatose state. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. After oral desmopressin, concentrations above the limit of quantification (2.5 pg/ml) were only detected in 51% of the samples. In the elderly, careful dosage selection and monitoring of renal function are recommended. The site is secure. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Doses may be titrated up to 0.6 mg PO once daily at bedtime, depending on individual patient response. Caution should be used when coadministering these agents. Oral doses of 0.2 and 0.4 mg produce similar responses on urine volume and urine osmolality as 0.01 mg and 0.02 mg intranasal doses. The initial and terminal half-lives for desmopressin are 7.8 and 75.5 minutes, respectively, resulting in a prompt onset of action with a long duration of action. 5 to 40 mcg spray intranasally twice a day or Clipboard, Search History, and several other advanced features are temporarily unavailable. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. 150 mcg into 1 nostril once for a total dose of 150 mcg. The optimal dosage depends on the patient's response (duration of sleep and adequate, not excessive water turnover). If used preoperatively, administer 2 hours before surgery. Clin Endocrinol (Oxf). Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. In general, dose selection for the geriatric patient should be cautious, usually starting at the low end of the dosing range. If used preoperatively, administer 30 minutes prior to the procedure. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Intranasal: Controls bleeding in certain types of hemophilia and von Willebrand's disease Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Caution should be used when coadministering these agents. Most adults require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. -. Limit fluid intake to a minimum 1 hour before and 8 hours after administration. 55.3 mcg sublingually once daily, 1 hour before bedtime without water. The recommended starting dose is 1 spray (0.83 mcg) in either the left or right nostril approximately 30 minutes before going to bed. Dextromethorphan; Guaifenesin; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. endobj Federal government websites often end in .gov or .mil. Patients changing from intranasal desmopressin: The recommended starting dose of DDAVP Injection is 1/10th the daily maintenance intranasal dose administered by subcutaneous or intravenous injection as one or two divided doses. Repeat administration should be determined by laboratory response and clinical condition of the patient. Bookshelf Cisplatin: (Moderate) Frequently monitor serum sodium levels if concurrent use of desmopressin and cisplatin is necessary. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. A woman who took both desmopressin and ibuprofen was found in a comatose state. Vasopressin, ADH: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like vasopressin, ADH only with careful patient monitoring. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Preoperative doses may be given 2 hours prior to the scheduled procedure. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Mefenamic Acid: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Dosage adjustments of desmopressin may be necessary to maintain proper sodium and water balance. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Lamotrigine: (Major) Caution is recommended if a drug that may increase the risk of water intoxication with hyponatremia, such as lamotrigine, is administered with desmopressin acetate. Oral dosage (capsules and tablets) Adults When desmopressin is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular pediatric and geriatric patients, fluid intake should be adjusted downward to decrease to potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain). Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Keep this seal as it is reversed to prevent leakage from the dropper.Squeeze the correct dose into this tube from the dropper bottle. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Methods: A woman who took both desmopressin and ibuprofen was found in a comatose state. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Monitor serum sodium concentrations within 1 week and then approximately 1 month after treatment initiation and periodically thereafter. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Flunisolide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin: Corticosteroids (Systemic) may enhance the hyponatremic . Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. TYPES OF IV TO PO THERAPY CONVERSIONS: There are three types of IV to PO therapy conversions as defi ned below: SEQUENTIAL THERAPY SWITCH THERAPY STEP DOWN THERAPY. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. For bleeding, desmopressin increases the blood levels of factor VIII and von Willebrand . Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. Blood samples were taken before and at predetermined time points up to 12 h after dosing. Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude the presence of factor VIII autoantibodies. If patients are receiving intranasal therapy, begin oral therapy 12 hours after last intranasal dose. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. Intermittently during treatment, assess serum sodium, urine volume and osmolality or plasma osmolality. Patients receiving intranasal treatment could begin oral therapy the night following (24 hours) the last intranasal dose. Dosing: Diabetes Insipidus x}n y)Zn91Iv l38Y8bIkYbX$=x:9\>?}st_~xOo^\~dt&&=\~o~g/}~y%;]V|s{h+j/~\f'iqriwZgI~IOk[b,n6'K+%Y{Y?k{]U4{H}mWRa |3}ktz_>iCy>VbZ{SZ(_!> _~{pz.5'Kxo'wW0P*okGa? The frequency of dosing varies with patient responses. Prior to treatment with DDAVP Injection, verify that factor VIII coagulant activity levels are >5% and exclude severe von Willebrand's disease (Type I) and presence of abnormal molecular form of factor VIII antigen. Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. Preoperative IV doses may be given 30 minutes prior to scheduled procedure. When switching from DDAVP Tablets to DDAVP Injection, titrate dose individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) due to the large variability in both PK and PD. more than 50 kg: 150 mcg in each nostril. Adult dosing should not be used in this age group; adverse events such as hyponatremia-induced seizures may occur. Ddavp, Nocdurna, Octostim. endobj A woman who took both desmopressin and ibuprofen was found in a comatose state. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. 8600 Rockville Pike As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. As of 2007 in response to a FDA request for removal of the indication, the intranasal formulation is no longer indicated for the treatment of primary nocturnal enuresis secondary to post-marketing reports of hyponatremic-related seizures, which most often occurred in pediatric patients. This site complies with the HONcode standard for trust- worthy health information: verify here. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. The recommended dose for women is lower than for men because women are more sensitive to the effects of desmopressin sublingual tablet and had a higher risk of hyponatremia with the 55.3 mcg dose in clinical trials. Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. 1999 Dec;84 Suppl 1:5-8 Main menu. Initiate fluid restriction during treatment with DDAVP Injection [see Warnings and Precautions (5.1), Use in Specific Populations (8.4, 8.5)]. Quinapril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. KEEP REFRIGERATED AT 2 to 8C (36 to 46F). During the initial titration period and continued therapy, observe and monitor closely. Paediatr Drugs. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. When switching between formulations, the below text is meant as guidance for starting dose. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Dosage form: injection Blood pressure and pulse should be monitored during infusion. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. Barnabei A, Corsello A, Paragliola RM, Iannantuono GM, Falzone L, Corsello SM, Torino F. Cancers (Basel). On Day 7, 6 subjects were given a single SC bolus injection of desmopressin. 1997;183:53-4. 1 0 obj 6 years or older: ADH activity : Pressor activity [DDAVP: 2000-4000: 1 Vasopressin: 1:1]. Only start or resume therapy in patients with a normal serum sodium concentration. Desmopressin nasal spray can be resumed when these conditions resolve. 150 mcg into each nostril once for a total dose of 300 mcg. Chlorpropamide: (Moderate) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including chlorpropamide. stream Acetaminophen; Dextromethorphan; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. For continuous infusions, conc. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Lidocaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Prednisolone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. During treatment with DDAVP Injection, assess serum sodium, bleeding time, factor VIII coagulant activity, ristocetin cofactor activity, and von Willebrand antigen to ensure that adequate levels are being achieved. Administer with a 0.22 micron filter. Cyclizine SC or IV Nausea and vomiting 0.5 1 14.5 0 Diamorphine$ SC or IV Pain 0.075 0.1 2.175 2.9 1.45 3.2625 Diazepam PR Agitation, convulsions 10 Hydrocortisone IV Anaphylaxis 2 4 58 116 Hyoscine hydrobromide SC or IV Respiratory tract secretions 0.01 0.01 0.29 0.29 Midazolam SC or IV Anxiety or agitation 0.06 0.1 1.74 2.9 2 4.5 In this study, efficacy and side effects of oral desmopressin. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. During initial titration and continued therapy, observe and monitor closely; adjust treatment to the diurnal pattern of response. A woman who took both desmopressin and ibuprofen was found in a comatose state. new homes for sale edmonton north personal chef near los angeles, ca personal chef near los angeles, ca 1990 Aug;66(2):175-6 When administered to patients with central diabetes insipidus, desmopressin exerts antidiuretic effects similar to those of vasopressin; a reduction in urine output with an accompanying increase in urine osmolality and a decrease in clinical symptoms of urinary frequency and nocturia are noted following desmopressin treatment. Adjust doses based on patient's diurnal pattern of response. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Response should be estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Use combination with caution and monitor patients for signs and symptoms of hyponatremia, which may include seizures. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Sulindac: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. In contrast to vasopressin, desmopressin does not induce the release of adrenocorticotropic hormone or increase plasma cortisol concentrations. An official website of the United States government. To prime, press down 4 times. YES. Response should be estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. Carbetapentane; Guaifenesin; Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring. Child 2-11 years Loop diuretics: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Azelastine; Fluticasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Consider risk vs. benefit as pregnant women with Hemophilia A or von Willebrand's disease as these patients may be at an increased risk for bleeding diatheses and hemorrhagic events at delivery; affected neonates may also be at risk of bleeding diatheses. Valdecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. IV: 0.3 mcg/kg once slowly over 15-30 minutes. This site needs JavaScript to work properly. Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. Bisoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Desmopressin is also used to control excessive thirst and the passage of an abnormally large amount of urine that may occur after a head injury or after certain types of surgery. Dosage: (For neonatal dosages, refer to Neonatal IV Drug Manual.) Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. Dose: 0.1-1.2 mg/day PO divided bid-tid; Start: 0.05 mg PO bid; Max: 1.2 mg/day; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; restrict fluid intake [parenteral route] Dose: 2-4 mcg/day SC/IV divided qd-bid; Info: parenteral dose is approx. Longer DOA. This is probably due to saturation of receptor sites. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Further hospitalization cost saving may be achieved through reduced Geriatric patients 65 years of age and older treated with desmopressin for nocturia had a higher incidence of hyponatremia compared to patients less than 65 years old; therefore, monitor serum sodium more frequently in these patients. ea1`-@te3;plr*5L%5Ko=UNed Dopamine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like dopamine only with careful patient monitoring. 1.2 mg/day PO, 4 mcg/day SC/IV; Alt: 2-4 mcg/day SC/IV divided qd-bid; Info: give 1st PO dose 12h after last intranasal dose when switching to PO; parenteral dose is approx. Captopril; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Treatment longer than 4 to 8 weeks has not been studied. For endotoxin-induced fever, IV is favored over PO acetaminophen in reducing temperature for up to . Proposed sites of these receptors include endothelial cells, megakaryocytes, blood monocytes, and mast cells. Aminophylline IV Push IV Push IV Push IV Push IV bolus infuse over 20 -30 minutes not to exceed 25 mg/min; max concentration 25 mg/ml. Diabetes Insipidus: < 12 years: No definitive dosing available. Conversion from oral to intranasal: Individual dose titration is required (intranasal desmopressin ~10- to 40-fold more potent than oral desmopressin). IV infusion . WBC count of 15,00/mm 2. Desmopressin acetate should not be used to treat patients with Type IIB von Willebrands disease since platelet aggregation may be induced. However, individualized dosing is recommended due to high inter-patient variability in response. Desmopressin is contraindicated in patients with moderate to severe renal impairment (defined as a creatinine clearance below 50 mL/min). If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. and transmitted securely. Vincristine Liposomal: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with SIADH including vincristine. Dose range is 0.1 to 0.8 mg daily. Hydrochlorothiazide, HCTZ; Moexipril: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The mechanism of action of desmopressin in Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Most patients respond to 1 to 2 doses; administer a second dose 8 to 24 hours after the first dose if needed. Beclomethasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Idiopathic partial central diabetes insipidus. Then i-Vents acuity will now have a 10 to signify there is a open i-Vent. Study results show the C max of IV acetaminophen is 76% greater than PO and 256% greater than PR. IV: 0.3 mcg/kg once slowly over 15-30 minutes. Available for Android and iOS devices. However, dose should always be titrated individually according to the diuresis (antidiuretic response) and electrolyte status (serum sodium) of the patient. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. A comparison was made of intranasal administration of 300 micrograms desmopressin (DDAVP) by spray, with intravenous administration of 0.2, 0.3 and 0.4 microgram DDAVP/kg in 10 healthy volunteers. Persons with vWD type 1 and von Willebrand factor (vWF) concentrations less than 0.3 International Units/mL or factor VIII activity equal to or less than 5% of normal may not respond to desmopressin. Determine need for repeat dosage based on laboratory response and patient's clinical condition. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. As her serum sodium concentration was 121 mmol/L, and her plasma osmolality was low in the presence of a high-normal urine osmolality and normal sodium excretion, she was treated with fluid restriction. IN 1977 DESMOPRESSIN (1-deamino-8-D-arginine vasopressin, abbreviated DDAVP), a derivative of the antidiuretic hormone, was used for the first time to treat patients with hemophilia A and von Willebrand disease (vWD), the most frequent congenital bleeding disorders. 1996 Sep;42(3):379-85 Initially, 10 mcg (0.1 mL) intranasally into 1 nostril, may increase to 40 mcg until the patient can sleep for an adequate period of time without incidence of polyuria. Phenylephrine: (Moderate) Although the pressor activity of desmopressin is very low compared to its antidiuretic activity, large doses of desmopressin should be used with other pressor agents like phenylephrine only with careful patient monitoring.

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