DDAVP (DESMOPRESSIN ACETATE, MINIRIN)

DDAVP (DESMOPRESSIN ACETATE, MINIRIN)

CLASSIFICATION

� Antidiuretic Hormone Analogue.

MODE OF ACTION

Actions can be summarised as follows: Antidiuretic action - DDAVP acts at a receptor site in the renal collecting tubule to increase permeability to water reabsorption. Effect on factor VIII:- High doses of DDAVP produce marked and sustained increases of factor VIII coagulant activity and Von Willebrand factor . Plasminogen activator is also released. Effect on bleeding time: - The exact mechanism of this effect is not known. It is thought that DDAVP exerts through its V2 receptor agonist activity.

INDICATIONS

� Diabetes Insipidus

 � As a diagnostic test to establish renal concentration capacity.

 � Bleeding in patients with platelet dysfunction.

� Help to stop bleeding in haemophilia A patients with episodes of spontaneous or trauma induced injuries such as hemathroses, I M,. Haematomas or mucosal bleeding.

CONTRA INDICATIONS

� Type IIb Von Willebrands disease.

PRECAUTIONS

� In the control of Diabetes Insipidus the lowest effective dose should be used. � DDAVP should not be administered to dehydrated or over hydrated patients.

� In haemophilia patients

. � Can cause minor decrease in diastolic or systolic blood pressure.

 � Caution needs to be taken with patients who have cardiovascular disease and the elderly.

� In outpatients with platelet dysfunction skin bleeding time should be monitored.

ADVERSE REACTIONS

 � Tachycardia.

 � Fall in diastolic blood pressure.

� Headache.

 � Nausea and vomiting.

 � Mild abdominal cramps.

 � Facial flushing.

 � Water intoxication from over hydration.

PRESENTATION

PARENTAL Desmopressin Acetate 4 mcg in 1 ml ampoule of an isotonic sterile solution, for I.V, I.M or S.C administration. Store a about 4

� in a refrigerator. Do not freeze.

DOSAGE AND ADMINISTRATION

DIABETIES INSIPIDUS

Average daily dose 10 - 40 mcg intranasally or 1 - 4 mcg by injection. 0.4 mcg/kg DDAVP I.V. diluted in 10 - 100 ml 0.9 % Saline given over 15 - 20 minutes.

INHERITED ACQUIRED PLATELET FUNTION DEFECTS

DDAVP is given at a dose of 0.3 mcg/kg diluted to 50 mls in 0.9 % saline over 30 minutes