Desmopressin
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Desmopressin (DDAVP®, Stimate®, Minirin®) is a synthetic drug that mimics the action of antidiuretic hormone, also known as arginine vasopressin. It may be taken nasally, intravenously, or through a recently developed pill.
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Chemistry
Desmopressin (1-desamino-8-d-arginine vasopressin) is a modified form of the normal human hormone arginine vasopressin, an octapeptide (a chain of eight amino acids).
Compared to vasopressin, desmopressin's first amino acid has been deaminated, and the arginine at the eighth position is in the levo rather than the dextro form (see stereochemistry).
Method of action
Desmopressin binds to V2 receptors in renal collecting ducts, increasing water resorption. It also stimulates release of factor VIII from platelets due to stimulation of the V1a receptor.
Desmopressin is degraded more slowly than recombinant vasopressin, and requires less frequent administration. In addition, it has little effect on blood pressure, while vasopressin may cause arterial hypertension.
Uses
Desmopressin is used to reduce urine production in central diabetes insipidus patients and to promote the release of von Willebrand factor and factor VIII in patients with coagulation disorders such as type I von Willebrand disease, hemophilia A, and thrombocytopenia. Desmopressin is not effective in the treatment of hemophilia B.
It may also be prescribed to reduce frequent bedwetting episodes in children by decreasing noctural urine production.
Side effects
See also
References
- Leissinger C, Becton D, Cornell C Jr, Cox Gill J. High-dose DDAVP intranasal spray (Stimate) for the prevention and treatment of bleeding in patients with mild haemophilia A, mild or moderate type 1 von Willebrand disease and symptomatic carriers of haemophilia A. Haemophilia 2001;7:258-66. PMID 11380629.de:Desmopressin