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Desmopressin (1-deamino-8-D-arginine vasopressin) is a synthetic form of the normal human hormone arginine vasopressin (the antidiuretic hormone, or ADH), a peptide containing nine amino acids. Compared to vasopressin, desmopressin's first amino acid has been deaminated , and the arginine at the eighth position is in the dextro rather than the ...
The water deprivation test (WDT) is a commonly used test for diabetes insipidus, a two-step process involving parenteral desmopressin administration after an initial 8-hour water fast. It differentiates primary polydipsia from diabetes insipidus and central diabetes insipidus from nephrogenic diabetes insipidus .
The antidiuretic hormone class includes vasopressin (ADH), argipressin, desmopressin, lypressin, ornipressin, oxytocin, and terlipressin. Miscellaneous others include chlorpropamide and carbamazepine .
Desmopressin will be ineffective in nephrogenic DI which is treated by reversing the underlying cause (if possible) and replacing the free water deficit. A thiazide diuretic , such as chlorthalidone or hydrochlorothiazide , can be used to create mild hypovolemia which encourages salt and water uptake in proximal tubule and thus improve ...
Vasopressin agonists are used therapeutically in various conditions, and its long-acting synthetic analogue desmopressin is used in conditions featuring low vasopressin secretion, as well as for control of bleeding (in some forms of von Willebrand disease and in mild haemophilia A) and in extreme cases of bedwetting by children.
Desmopressin can also be used; if the patient is able to concentrate urine following administration of desmopressin, then the cause of the diabetes insipidus is neurogenic diabetes insipidus; if no response occurs to desmopressin, then the cause is likely to be nephrogenic.
The peptide analogue desmopressin is, for example, available for both nasal and oral administration, for the treatment of diabetes insipidus. The bioavailability of the commercial tablet is 0.1% while that of the nasal spray is 3-5% according to the SPC ( Summary of Product Characteristics ). [ 16 ]
The most prominent vasopressin analogues include desmopressin (dDAVP), terlipressin, and selepressin, each with distinct pharmacological profiles and clinical uses. Desmopressin, a V2 receptor agonist, is primarily used for treating diabetes insipidus and certain bleeding disorders. [ 3 ]