При гемофилии и болезни Виллебранда, десмопрессин эффективен, .. Rose EH, Aledort LM: Nasal spray desmopressin (DDAVP) for mild of desmopressin acetate (DDAVP) on postoperative blood loss after cardiac. Download Citation on ResearchGate | Nasal administration of desmopressin by spray and drops | A solution of desmopressin was administered intranasally as a Antidiuretic Response to Desmopressin Acetate Administered Transdermally. PDF | Desmopressin acetate is the synthetic analogue of the antidiuretic rabbit nasal mucosa in vitro than a commercial liquid nasal spray loaded at the same.
Transf Med Rev 5: Десмопрессин также использовался для профилактики кровотечений у больных, подвергающихся хирургическим academic allergies, обусловленными большой потерей крови и необходимым ее пополнением. Acta Physiol Pol 8: Они показали, что усиление свертывания крови, связанное со стрессом, было вызвано выделением в плазму адреналина. Неудачи при клиническом применении десмопрессина можно объяснять недостатком уровня фактора VIII в плазме крови, desmopressin acetate nasal spray. Десмопрессин сокращает длительность активации тромбопластина и время периода кровотечения. Это снижает длительность кровотечения desmopressin acetate nasal spray людей, принимающих широко используемые препараты типа аспирина, продлевающих кровотечение и инициирует частичный тромбопластин у больных, принимающих гепарин, и снижает продолжительность кровотечения у кроликов, обработанных стрептокиназой или гирудином.
Dosing & Uses
For some sufferers, steam inhalation is considered in treating sinus problems. The influence of adrenaline in blood coagulation. Desmopressin and bleeding time in patients with cirrhosis. Warrier L, Lusher JM: Stuttgart, Germany, Schattauer Verlag, , p Гемостатический дефект при уремии характеризован удлиннением времени кровотечения - лабораторная аномалия, которая коррелируется строго с геморрагическими признаками тех больных, у кого наблюдается главным образом носовые и желудочно-кишечного кровотечения. Десмопрессин - не единственный препарат, сохраняющий объем циркулирующей крови, используемый при операциях. В Соединенных Штатах, например, где в период гг. В настоящее время, широкое применение эритропоэтина и результаты установившейся коррекции гемостатического дефекта делает использование десмопрессин бесполезным у большей части больных с хронической почечной недостаточностью.
The multipotent drug in patients with coagulopathies. Точно не установлено, соответствует ли эффект уменьшение времени кровотечения desmopressin acetate nasal spray эффекту. Bleeding time prolongation with streptokinase and its reduction with 1-deaminoD-arginine vasopressin. По прошествии двадцати лет после первого клинического применения, препарат все еще используется для лечения больных с легкой и средней формами гемофилии А и болезнью Виллебранда тип 1. For some sufferers, desmopressin acetate nasal spray, steam inhalation is considered in treating sinus problems. Factor VIII activity and antigen, platelet count and biochemical changes after adrenoceptor stimulation.
Central Serous Chorioretinopathy Associated with Desmopressin Nasal Spray
It is chemically defined as follows:. DDAVP desmopressin acetate tablets Tablets are indicated as antidiuretic replacement therapy in the management of central diabetes insipidus and for the management of the temporary polyuria and polydipsia following head trauma or surgery in the pituitary region. DDAVP desmopressin acetate tablets is ineffective for the treatment of nephrogenic diabetes insipidus. Continued response to DDAVP desmopressin acetate tablets can be monitored by measuring urine volume and osmolality.
DDAVP desmopressin acetate tablets Tablets are indicated for the management of primary nocturnal enuresis. DDAVP desmopressin acetate tablets may be used alone or as an adjunct to behavioral conditioning or other non-pharmacologic intervention. The dosage of DDAVP desmopressin acetate tablets Tablets must be determined for each individual patient and adjusted according to the diurnal pattern of response.
Response should be estimated by two parameters: Patients previously on intranasal DDAVP desmopressin acetate tablets therapy should begin tablet therapy twelve hours after the last intranasal dose.
During the initial dose titration period, patients should be observed closely and appropriate safety parameters measured to assure adequate response.
Patients should be monitored at regular intervals during the course of DDAVP desmopressin acetate tablets Tablet therapy to assure adequate antidiuretic response. Modifications in dosage regimen should be implemented as necessary to assure adequate water turnover. Fluid restriction should be observed, desmopressin acetate nasal spray.
It is recommended that patients be started on doses of 0. Most patients in clinical trials found that the optimal dosage range is 0. Each dose should be separately adjusted for an adequate diurnal rhythm of water turnover, desmopressin acetate nasal spray.
Total daily dosage should be increased or decreased in the range of 0. See Pediatric Use subsection for special considerations when administering desmopressin acetate to pediatric diabetes insipidus patients. This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
The dosage of DDAVP desmopressin acetate tablets Tablets must be determined for each individual patient and adjusted according to response. Patients previously on intranasal DDAVP desmopressin acetate tablets therapy can begin tablet therapy the night following 24 hours after the last intranasal dose.
The recommended initial dose for patients age 6 years and older is 0. The dose may be titrated up to 0. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before desmopressin administration, until the next morning, or at least 8 hours after administration. Avoid exposure to excessive heat or light. Infrequently, large doses of the intranasal formulations of DDAVP desmopressin acetate tablets and DDAVP desmopressin acetate tablets Injection have produced transient headache, nauseaflushing and mild abdominal cramps.
These symptoms have disappeared with reduction in dosage. The following adverse events have been reported; however their relationship to DDAVP desmopressin acetate tablets has not been established: There have been rare reports of hyponatremic convulsions associated with desmopressin acetate nasal spray use with the following medications: Although the pressor activity of DDAVP desmopressin acetate tablets is very low compared to its antidiuretic activity, large doses of DDAVP desmopressin acetate tablets Tablets should be used with other pressor agents only with careful patient monitoring.
The concomitant administration of drugs that may increase the risk of water intoxication with hyponatremia, desmopressin acetate nasal spray, e. Intranasal formulations of DDAVP desmopressin acetate tablets at high doses and DDAVP desmopressin acetate tablets Injection have infrequently produced a slight elevation of blood pressure which disappears with a reduction of dosage. Although this effect has not been observed when single oral doses up to 0. DDAVP desmopressin acetate tablets should be used with caution in patients with conditions associated with fluid desmopressin acetate nasal spray electrolyte imbalance, such as cystic fibrosisheart failure and renal disorders because these patients are prone to hyponatremia.
Laboratory tests for monitoring the patient with central diabetes insipidus or post-surgical or head trauma-related polyuria and polydipsia include urine volume and osmolality, desmopressin acetate nasal spray.
In some cases, measurements of plasma osmolality may be useful. Carcinogenicity, Mutagenicity, Impairment of Fertility: Studies with DDAVP desmopressin acetate tablets have not been performed to evaluate carcinogenic potential, mutagenic potential or effects on fertility.
Fertility studies have not been done. Teratology studies in rats and rabbits at doses from 0. There are, however, no adequate and well-controlled studies in pregnant women. Because animal studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Several publications where desmopressin acetate was used in the management of diabetes insipidus during pregnancy are available; these include a few anecdotal reports of congenital anomalies and low birth weight babies.
However, no causal connection between these events and desmopressin acetate has been established. A fifteen year Swedish epidemiologic study of the use of desmopressin acetate in pregnant women with diabetes insipidus found the rate of birth defects to be no greater than that in the general population; however, the statistical power of desmopressin acetate nasal spray study is low.
As opposed to preparations containing natural hormones, desmopressin acetate in antidiuretic doses has no uterotonic action and the physician will have to weigh the possible therapeutic advantages against the possible risks in each case. There have been no controlled studies in nursing mothers, desmopressin acetate nasal spray. A single study in postpartum women demonstrated a marked change in plasma, desmopressin acetate nasal spray, but little if any change in assayable DDAVP desmopressin acetate tablets in breast milk following an intranasal dose of 0.
It is not known whether the drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when DDAVP desmopressin acetate tablets is administered to nursing mothers. DDAVP Tablets desmopressin acetate have been used safely in pediatric patients, age 4 years and older, with diabetes insipidus for periods up to 44 months.
In younger pediatric patients the dose must be individually adjusted in order to prevent an excessive decrease in plasma desmopressin acetate nasal spray leading to hyponatremia and possible convulsions; dosing should start at 0.
Use of DDAVP desmopressin acetate tablets Tablets in pediatric patients requires careful fluid intake restrictions to prevent possible hyponatremia and water intoxication. DDAVP desmopressin acetate tablets Tablets have been safely used in pediatric patients age 6 years and desmopressin acetate nasal spray with primary nocturnal 75 dont want dem healthcare plan for up to desmopressin acetate nasal spray months.
Some patients respond to a dose of 0. No increase in the frequency or severity of adverse reactions or decrease in efficacy was seen with an increased dose or duration. The dose should be individually adjusted to achieve the best results. Clinical studies of DDAVP desmopressin acetate tablets Tablets did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.
Other desmopressin acetate nasal spray clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, desmopressin acetate nasal spray, renal, or cardiac function, and of concomitant disease or other drug therapy.
Use of DDAVP desmopressin acetate tablets Tablets in geriatric patients requires careful fluid intake restrictions to prevent possible hyponatremia and water intoxication. Fluid restriction should be discussed with the patient. Signs of overdose may include confusion, drowsiness, continuing headache, problems with passing urine and rapid weight gain due to fluid retention.
In case of overdose, the dose should be reduced, frequency of administration decreased, or the drug withdrawn according to the severity of the condition. The patient should be observed and treated with appropriate symptomatic therapy. An oral LD50 has not been established.
Oral doses up to 0, desmopressin acetate nasal spray. DDAVP desmopressin acetate tablets Tablets are contraindicated in individuals with known hypersensitivity to desmopressin acetate or to any of the components of DDAVP desmopressin acetate tablets Tablets.
DDAVP desmopressin acetate tablets is contraindicated in patients with hyponatremia or a history of hyponatremia. DDAVP desmopressin acetate tablets Tablets contain as active substancedesmopressin acetatea desmopressin acetate nasal spray analogue of the natural hormone arginine vasopressin.
Dose desmopressin acetate nasal spray studies in patients with diabetes insipidus have demonstrated that oral doses of 0. In most patients, doses of 0. With doses of 0. Increasing oral desmopressin acetate nasal spray produced dose dependent increases in the plasma levels of DDAVP desmopressin acetate.
Following administration of DDAVP desmopressin acetate tablets Tablets, desmopressin acetate nasal spray, the onset of antidiuretic effect occurs at around 1 hour, and it reaches a maximum at about 4 to 7 hours based on the measurement of increased urine osmolality.
The use of DDAVP desmopressin acetate tablets Tablets in patients with an established diagnosis will result in a reduction in urinary output with an accompanying increase in urine osmolality. These effects usually will allow resumption of a more normal life style, with a decrease in urinary frequency and nocturia. Usually, the change occurred over a period of time greater than six months.
This change may be due to decreased responsiveness, or to shortened duration of effect. There is no evidence that this effect is due to the development of binding antibodies, but may be due to a local inactivation of the peptide.
No lessening of effect was observed in the 46 patients who were treated with DDAVP desmopressin acetate tablets Tablets for 12 to 44 months and no serum antibodies to desmopressin were detected. The change in structure of arginine vasopressin to desmopressin acetate resulted in less vasopressor activity and decreased action on visceral smooth muscle relative to enhanced antidiuretic activity.
Consequently, clinically effective antidiuretic doses are usually below the threshold for effects on vascular or visceral smooth muscle. In the four long-term studies of DDAVP desmopressin acetate tablets Tablets, no increases in blood pressure in 46 patients receiving DDAVP desmopressin acetate tablets Tablets for periods of 12 to 44 months were reported. In one study, the pharmacodynamic characteristics of DDAVP desmopressin acetate tablets Tablets and intranasal formulation were compared during an 8-hour dosing interval at steady state.
The doses administered to 36 hydrated water loaded healthy male adult volunteers every 8 hours were 0. The results are shown in the following table:. While both the 0. In another study in diabetes insipidus patients, the pharmacodynamic characteristics of DDAVP desmopressin acetate tablets Tablets and intranasal formulations were compared over a hour period. Ten fluid-controlled patients under age 18 were administered tablet doses of 0.
All four dose formulations 0. Mean plasma osmolality remained relatively constant over the time course recorded 0 to 12 hours. A statistical separation desmopressin acetate nasal spray baseline did not occur at any dose or time point. In these patients, the 0.
In another study of adult diabetes insipidus patients previously controlled on. Two double-blindrandomizedplacebo-controlled studies were conducted in patients with primary nocturnal enuresis, desmopressin acetate nasal spray.
A total of patients were evaluated for efficacy. Patients were evaluated over a two-week baseline period in which the average number of wet nights was 10 range
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