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. 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. Inject subcutaneously taking care not to inject intradermally. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. WARNINGS When Desmopressin Acetate Injection is administered to patients who do not have need of antidiuretic hormone for its antidiuretic effect, in particular in pediatric and geriatric patients, fluid intake should be adjusted downward to decrease the potential occurrence of water intoxication and hyponatremia with accompanying signs and symptoms (headache, nausea/vomiting, decreased serum sodium and weight gain). The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Diclofenac; Misoprostol: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. Sodium is corrected by infusing hypertonic solutions, primarily 3% saline. 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. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Chlorthalidone; Clonidine: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. 1998 Nov;82(5):642-6 Desmopressin (dDAVP), a synthetic analogue of 8-arginine vasopressin (ADH), is an antidiuretic . DrugBank Accession Number. Azilsartan; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Most patients require a maintenance dose of 20 mcg/day, administered as 10 mcg intranasally twice daily. If there is no response, the medication will be stopped. 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. IV: 0.3 mcg/kg once slowly over 15-30 minutes. 1 to 2 mcg IV every 6 to 8 hours in combination with hypertonic saline. Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. Hemophilia A and von Willebrand's Disease (Type I): The recommended dosage is 0.3 mcg/kg actual body weight (to a maximum of 20 mcg) administered by intravenous infusion over 15 minutes to 30 minutes. A woman who took both desmopressin and ibuprofen was found in a comatose state. Intranasal: WBC count of 3,000mm 3. Desmopressin is present in small amounts in human milk and is poorly absorbed by an infant. Preoperative doses may be given 2 hours prior to the scheduled procedure. Dependent on route of administration and indication for therapy. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer. Typical maintenance dose was 10 to 40 mcg/day (0.1 to 0.4 mL/day). endobj
8-10 mg IV = 40 mg PO. Metolazone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. IV Push for Hyperkalemia. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. Subcutaneously: 1 to 2 mcg twice a day Her serum sodium concentration was 124 mmol/L within a day and was 135 mmol/L by the second day. WBC count of 15,00/mm 2. Intranasal: 1 spray (1.5 mg/mL) in each nostril one time. ea1`-@te3;plr*5L%5Ko=UNed 1. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Methods: The study had an open, randomised, four-way cross-over design. Carbetapentane; Chlorpheniramine; 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. 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. Drugs; . So, if a patient is on a nasal (spray or intranasal) dose of 10mcg (0.1 ml) twice a day, then a suitable tablet oral dose may be 100mcg or 200mcg twice a day. Atenolol; Chlorthalidone: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. The pharmacist leaving the sticky not will open and IV to po i-Vent, leave this i-Vent open until the medication is changed. 1. The morning and evening doses should be separately adjusted for an adequate diurnal rhythm of water turnover. Cortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. 1996 Sep;42(3):379-85 Once the dose is in the tube, hold the tube with your fingers, about 3/4 inch from the end.Put the tube into a nostril, until your fingers touch the nostril. The plasma concentrations generally declined below 2 pg/mL (lower limit of quantitation) 4 to 6 hours post-dose. Hyponatremia-induced convulsions have been rarely reported when imipramine and desmopressin are used concomitantly. Generic:- Closed containers will maintain stability for 3 weeks at controlled room temperature (68 to 77 degrees F)- Refrigerate (between 36 and 46 degrees F)DDAVP:- Discard product if it contains particulate matter, is cloudy, or discolored- Store in refrigerator at 2 to 8 degrees C (36 to 46 degrees F)Minirin:- Store at 77 degrees F; excursions permitted to 59-86 degrees F- Store uprightNocdurna:- Product should always be stored in the blister and only removed immediately before use- Protect from moisture- Store between 68 to 77 degrees F, excursions permitted 59 to 86 degrees F- Store in the original carton to protect from lightNoctiva:- Product must be used within 60 days after removal from refrigeration to room temperature (77 degrees F)- Store in refrigerator (36 to 46 degrees F), excursions permitted between 32 to 59 degrees F- Store uprightStimate:- Store at room temperature (up to 77 degrees F)- Store upright. In certain clinical situations, it may be justified to try desmopressin in persons with factor VIII concentrations of 2% to 5%; however, carefully monitor these patients. The initial response is reproducible if DDAVP is administered every 2 to 3 days. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Ibuprofen; Oxycodone: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 150 mcg into 1 nostril once for a total dose of 150 mcg. Articaine; Epinephrine: (Minor) The antidiuretic response to desmopressin may be reduced in patients receiving high doses of epinephrine concomitantly. The following pharmacist will check on these open i-Vents and close then when appropriate. Clin Endocrinol (Oxf). Dose range is 5 to 30 mcg/day. During initial titration and continued therapy, observe and monitor closely; adjust treatment to the diurnal pattern of response. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Naproxen; Esomeprazole: (Major) Additive hyponatremic effects may be seen in patients treated with desmopressin and drugs associated with hyponatremia including NSAIDs. 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. Determine need for repeat dosage based on laboratory response and patient's clinical condition. Administration of intranasal desmopressin may be compromised by nasal mucosa changes (e.g., nasal trauma, nasal surgery, nasal blockage, nasal mucosal atrophy, congestion, or severe atrophic rhinitis), cranial surgery, and nasal packing. The risk of toxic reactions (including water intoxication and low sodium concentrations) appears to be greater in the geriatric patient and other patients with impaired renal function. Response to vasopressin is mediated through two receptors: the V1 receptor, which mediates smooth muscle contraction in the peripheral vasculature, and the V2 receptor, which regulates water resorption in the collecting ducts. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. <>/Metadata 485 0 R/ViewerPreferences 486 0 R>>
Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. A woman who took both desmopressin and ibuprofen was found in a comatose state. The woman had previously received desmopressin without the development of clinical symptoms of hyponatremia Fludrocortisone: (Major) Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Response should be estimated by two parameters: adequate duration of sleep and adequate, not excessive, water turnover. 1 After the original clinical study performed in Italy, desmopressin was used in Child 2-11 years Chronic desmopressin administration may result in changes to nasal mucosa (scarring and edema), which may cause erratic and unreliable absorption. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma. doi: 10.31744/einstein_journal/2023RC0124. Peak plasma concentration (Cmax) was 6.2 (5.1-7.5) pg/ml at night and 6.6 (5.5-7.9) pg/ml in the daytime. Use combination with caution, and monitor patients for signs and symptoms of hyponatremia. Amiloride; Hydrochlorothiazide, HCTZ: (Moderate) Monitor serum sodium more frequently during concomitant desmopressin and thiazide diuretic use due to increased risk of water intoxication with hyponatremia. .2/ZfG[:{oH}ZJUmniOF F.\6K"abU:hiVyz6gAKt_|pgrqx9MUWz,_LgMvU ?>MJx
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desmopressin iv to po conversion