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. I would recommend making an appointment with your regular doctor to see what might be causing this. Treatment has been given safely to pediatric patients for up to 6 months. 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. The necessity for repeat administration of DDAVP or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. . [61810], 2 to 4 mcg IV or subcutaneously given in 1 to 2 divided doses daily. 2022 Mar 21;13:840971. doi: 10.3389/fendo.2022.840971. common IV -> PO conversions & some dosing Flashcards | Quizlet Proposed sites of these receptors include endothelial cells, megakaryocytes, blood monocytes, and mast cells. 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. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. hydrochlorothiazide, nortriptyline, tranexamic acid, imipramine, desmopressin, Pamelor, Microzide, vasopressin, Tofranil. government site. Blood pressure and heart rate monitoring during infusion is recommended. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Famotidine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Also assess serum sodium and aPTT prior to treatment. DDAVP Injection (desmopressin acetate) dose, indications, adverse - PDR Azilsartan; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Desmopressin is primarily excreted in the urine, with a significant portion excreted as unchanged drug (65% after oral and 92% after intranasal administration). Confirm responsiveness before using desmopressin for therapeutic interventions. 3 0 obj Desmopressin intranasal formulations are no longer indicated for the treatment of primary nocturnal enuresis due to the risk for developing severe hyponatremia that can result in seizures and death. 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. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. At two hours after . Generic Name. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. If there are dry nights after Desmopressin is used, continue using it for 3 months and then review your child's progress. The previously recommended dose: 20 mcg (0.2 mL) intranasally of the 0.01% nasal solution at bedtime, with one-half of the dose administered into each nostril. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Conversion of IV Midazolam. Dose range is 5 to 30 mcg/day. Following oral administration, the half-life of desmopressin is about 1.5 to 2.5 hours and is independent of dosage. stream The pump will stay primed for up to 1 week. 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. Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. Store refrigerated 2 to 8C (36 to 46F). Desmopressin has slight structural variations that reduce its affinity for V1 receptors and lessen its vasopressin activity and contractile action on visceral smooth muscle. An official website of the United States government. 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Hydrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin may promote an increased exposure of platelet vWF to GPIIb/IIIa on the platelet surface upon activation of the platelet. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Olopatadine; Mometasone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Caution should be used when coadministering these agents. Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Nclex ATI Live Review - pearsonvue/NCLEX On day of exam - Bring a valid Adjust doses based on patient's diurnal pattern of response. -, BJU Int. Dosing: Diabetes Insipidus Step-down therapy: changing to an oral drug that is a different compound and has different frequency, dose, or spectrum of activity. Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. They should also avoid drinks containing caffeine and alcohol before bedtime. Desmopressin Dosage Guide + Max Dose, Adjustments - Drugs.com Bioavailability was estimated using AUC(0-->t) for the oral and the intravenous periods. Hydralazine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 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. Losartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Decompensated Hypothyroidism ("Myxedema Coma") - EMCrit Project Desmopressin acetate 200 microgram tablets; 10microgram/mL WCHN The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diphenhydramine; Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. If the patient was previously receiving desmopressin injection, administer 10 times the amount of desmopressin acetate, rounding down to the nearest 10 mcg. Rotoli BM, Visigalli R, Ferrari F, Ranieri M, Tamma G, Dall'Asta V, Barilli A. Biomolecules. The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Sumatriptan; Naproxen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Plasminogen activator activity increases after intravenous desmopressin, but clinically significant fibrinolysis has not been detected in patients treated with desmopressin. Chlorpromazine: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with water intoxication, hyponatremia, or SIADH including chlorpromazine. September, 2004 Hospira 2004 EN-0511 Printed in USA HOSPIRA, INC., LAKE FOREST, IL 60045 USA. Desmopressin is not effective in persons with type 3 von Willebrand's disease (vWD) and can cause platelet aggregation, thrombocytopenia, and possibly thrombosis in persons with type 2B vWD. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. Med Surg ATI Proctored Exam Test Bank A 1 Desmopressin is contraindicated in patients with known hypersensitivity to desmopressin or any ingredients in the preparation. IV infusion IV Infusion IV Infusion (OB) Only REGULAR insulin may be administered by the IV route. Dilution Desmopressin (DDAVP ) - GlobalRPH Initiate fluid restriction during treatment with DDAVP Injection [see Warnings and Precautions (5.1), Use in Specific Populations (8.4, 8.5)]. Bendroflumethiazide; Nadolol: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Intranasal: Wash the rhinal tube in water and shake well, until no water is left in the tube.To avoid the spread of infection, do not use the container for more than 1 person.For 2.5 mL bottles, discard after 25 sprays (doses) because the amount delivered thereafter per spray may be substantially less than the recommended dose. 150 mcg into each nostril once for a total dose of 300 mcg. Fifteen healthy men aged 55-70 years were included in the analysis. Permanently discontinue for serious hypersensitivity reaction. Antidiuretic effects usually occur within 15 to 60 minutes, with peak effects evident 1 to 5 hours after nasal administration. For the treatment of hypothyroidism of any etiology, except during the recovery phase of subacute thyroiditis; used as a replacement in primary (thyroidal), secondary (pituitary), tertiary (hypothalamic), congenital (cretinism), or acquired hypothyroidism. 1. Ciclesonide: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 1999 Dec;84 Suppl 1:5-8 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. 1990 Aug;66(2):175-6 Aliskiren; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. DDAVP Nasal Spray (desmopressin acetate) Rx only DESCRIPTION DDAVP Nasal Spray (desmopressin acetate) is a synthetic analogue of the natural pituitary hormone 8-arginine vasopressin (ADH), an antidiuretic hormone affecting renal water conservation. Put the other end of the tube into the patients mouth; the patient should hold their breath.Tilt the patient's head back and have them blow with a short strong puff through the tube. Desmopressin Acetate Injection 4 mcg/mL dosage must be determined for each patient and adjusted according to the pattern of response. Desmopressin increases plasma factor VIII (FVIII) and von Willebrand factor (vWF) to a greater extent than equivalent weights of vasopressin. endobj Adjust dose based upon response to treatment estimated by 2 parameters: adequate duration of sleep and adequate, not excessive, water turnover. 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. If patients are receiving intranasal therapy, begin oral therapy 12 hours after last intranasal dose. Fluid restriction was to be observed, with fluid intake was limited to a minimum from 1 hour before intranasal administration, until the next morning, or at least 8 hours after administration. The time to reach maximum plasma desmopressin levels is 0.9 hours. Monitor serum sodium concentrations within 1 week and then approximately 1 month after treatment initiation and periodically thereafter. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 792 612] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fenoprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. If patients are receiving intranasal therapy, begin oral therapy 12 hours after the last intranasal dose. anaphylactoid reactions / Rapid / 0-1.0anaphylactic shock / Rapid / 0-1.0seizures / Delayed / Incidence not knownwater intoxication / Delayed / Incidence not knowncoma / Early / Incidence not knownthrombosis / Delayed / Incidence not knownthromboembolism / Delayed / Incidence not knownstroke / Early / Incidence not knownmyocardial infarction / Delayed / Incidence not known, hyponatremia / Delayed / 0.9-12.0hypertension / Early / 1.7-2.6photophobia / Early / 0-2.0conjunctivitis / Delayed / 0-2.0confusion / Early / Incidence not knownelevated hepatic enzymes / Delayed / Incidence not knownhypotension / Rapid / Incidence not knownsinus tachycardia / Rapid / Incidence not knownpalpitations / Early / Incidence not knowninfertility / Delayed / Incidence not knownbalanitis / Delayed / Incidence not knowntolerance / Delayed / Incidence not known, xerostomia / Early / 0-14.0rhinitis / Early / 3.0-8.0headache / Early / 2.0-5.0pharyngitis / Delayed / 2.3-3.8dizziness / Early / 0-3.0epistaxis / Delayed / 2.0-3.0nasal congestion / Early / 1.4-2.9sneezing / Early / 2.3-2.6back pain / Delayed / 1.1-2.3chills / Rapid / 0-2.0asthenia / Delayed / 0-2.0rhinalgia / Early / 2.0-2.0ocular pruritus / Rapid / 0-2.0lacrimation / Early / 0-2.0diarrhea / Early / Incidence not knownabdominal pain / Early / Incidence not knowndyspepsia / Early / Incidence not knownnausea / Early / Incidence not knownlethargy / Early / Incidence not knownflushing / Rapid / Incidence not knowncough / Delayed / Incidence not knowninjection site reaction / Rapid / Incidence not knownoligospermia / Delayed / Incidence not known. Initially, 0.05 mg PO once daily. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. The antidiuretic effects of the drug last for about 5 to 21 hours, followed by an abrupt cessation of activity that occurs over a 60- to 90-minute period. BJU Int. Generic name: DESMOPRESSIN ACETATE 4ug in 1mL Dosage form: injection Drug class: Antidiuretic hormones Medically reviewed by Drugs.com. 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. Ibuprofen: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. Vasopressin also causes constriction of vascular smooth muscle and contraction of smooth muscle in the GI tract and uterus. endobj Desmopressin: MedlinePlus Drug Information Repeat administration should be determined by laboratory response and clinical condition of the patient. 1183.34 Please enable it to take advantage of the complete set of features! WBC count of 3,000mm 3. If used preoperatively, administer 2 hours before surgery. Further hospitalization cost saving may be achieved through reduced PDF Comparison of intranasal and oral desmopressin nocturnalenuresis Diabetes insipidus: 2-4 mcg/day IV push or SC. Brand Names. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Desmopressin | Davis's Drug Guide for Rehabilitation Professionals | F Available for Android and iOS devices. Dose range is 0.1 to 1.2 mg divided into 2 or 3 doses. Adjust morning and evening doses separately for an adequate diurnal rhythm of water turnover. 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. Commonly central DI is treated with desmopressin. Diabetes Insipidus: < 12 years: No definitive dosing available. The necessity for repeat administration of desmopressin acetate or use of any blood products for hemostasis should be determined by laboratory response as well as the clinical condition of the patient. IV Push for Hyperkalemia. Tachyphylaxis (lessening of response) with repeated administration (i.e., given more frequently than every 48 hours) may occur. However, desmopressin is used off-label as a single injection for uremic bleeding in persons with renal failure. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. Dosage form: injection It is not known whether antibodies to desmopressin injection are produced after repeated injections. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Children younger than 12 years of ageUse and dose must be determined by your doctor. Indications and dose Diabetes insipidus, treatment By mouth Child 1-23 months Initially 10 micrograms 2-3 times a day, adjusted according to response; usual dose 30-150 micrograms daily. Desmopressin acetate should not be used to treat patients with Type IIB von Willebrands disease since platelet aggregation may be induced. Infusion Pump Required. 1 0 obj If the product has not been used for a period of 1 week, re-prime the pump by pressing once.Instruct patient on the proper technique for administering the nasal spray. 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. The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose. Use these drugs together with caution, and monitor patients for signs and symptoms of hyponatremia. It may be given in the nose, by injection into a vein, by mouth, or under the tongue. 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. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Irbesartan; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Baseline renal function should be assessed. 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. Find medical information for DDAVP on epocrates online, including its dosing, contraindications, drug interactions, and pill pictures. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before administration, until the next morning, or at least 8 hours after administration. This site complies with the HONcode standard for trust- worthy health information: verify here. 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. Ethacrynic Acid: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. Alternatively, if the patient was previously receiving intranasal therapy, the usual dose is one-tenth (1/10) of the intranasal maintenance dose. 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. Bethesda, MD 20894, Web Policies Desmopressin nasal spray can be resumed when these conditions resolve. Torsemide: (Contraindicated) Desmopressin is contraindicated with concomitant loop diuretic use due to an increased risk of hyponatremia. The peak cerebrospinal fluid concentrations are 60% greater with IV administration than with PO and 87% greater with IV administration than with PR. Fill in the blank - Do not enter the label - Rounding - Verify answer - Conversions - Practice questions. Increased FVIII and vWF levels are thought to be due to their release from endogenous reservoirs and not increased synthesis since the response is so rapid. If no response after 3 days, the dose was adjusted upward to 40 mcg/day (20 mcg per nostril) intranasally at bedtime. 1.5-2 mg IM/SC = 6-7 mg PO. 5 to 40 mcg spray intranasally twice a day or The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Tolvaptan: (Major) Coadministration of tolvaptan and desmopressin (DDAVP) is not recommended. His endocranologist only wants him to use it one time a day, but the problem is he goes to the bathroom sometimes every 15 minutes!!! A woman who took both desmopressin and ibuprofen was found in a comatose state. Inclusion Criteria for IV to PO Conversion: Infections that Require IV Antibiotics Must satisfy below criteria: Tolerate oral diet or enteral nutrition and/or receiving oral medications Infection does not require IV antibiotics Afebrile (< 100.4F in the last 24 hours) Received 24 hours of IV antibiotics Acetaminophen; 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. Missed Dose Drug class: Antidiuretic hormones. Celecoxib: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. 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. Dextromethorphan; Diphenhydramine; 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.