Comparative Study of Intranasal, Subcutaneous and Intravenous Administration of Desamino-D-Arginine Vasopressin (DDAVP)

Köhler, Michael; Hellstern, Peter; Miyashita, C.; Blohn, G. von; Wenzel, E.

doi:10.1055/s-0038-1661458

Cited by 69 publications

(24 citation statements)

References 24 publications

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“…To our knowledge relative resistance to nasal desmopressin in cranial diabetes insipidus has not previously been described and the pathophysiology of this phenomenon remains unclear. The routes of desmopressin administration have been studied previously in children with nocturnal enuresis [4] and healthy volunteers [5], but no difference in efficacy was found between routes of administration. The efficacy of desmopressin has been reported to be decreased in allergic diathesis [6], but our patient had no history of rhinitis or bronchospasm.…”

Section: Discussionmentioning

confidence: 99%

Lymphoma Metastasizing to the Pituitary: An Unusual Presentation of a Treatable Disease

et al. 2005

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Lymphoma involving the pituitary gland is particularly rare. We present two cases of patients with pituitary lymphoma, both of whom were symptomatic from pituitary dysfunction. The first patient demonstrated pituitary involvement on imaging, with mild biochemical diabetes insipidus but clear hypoadrenalism. Both adrenals were grossly enlarged on CT scanning and biopsy of one of the adrenal masses confirmed the diagnosis of diffuse large B cell lymphoma. The second patient presented with clinical diabetes insipidus but with no obvious abnormalities on pituitary imaging. CT scanning of abdomen and pelvis, however, revealed widespread lymphadenopathy. Lymph node biopsy revealed a T cell-rich B cell lymphoma. Review of the English-language literature of all published cases of pituitary lymphoma in the presence of generalised disease in immunocompetent patients revealed 13 cases. Most patients had large B cell non-Hodgkin's lymphoma. Involvement of the anterior lobe of the pituitary was more frequently seen than in patients developing pituitary metastases from solid tumour primaries. Patients with advanced lymphoma including the pituitary also appear to have a better prognosis than patients presenting with pituitary metastases. This is an important diagnosis to make as rapidly as possible to allow the early institution of effective therapy.

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Section: Discussionmentioning

confidence: 99%

Lymphoma Metastasizing to the Pituitary: An Unusual Presentation of a Treatable Disease

et al. 2005

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“…The kinetics of the FVIII and vWF responses after desmopressin have been studied before. In healthy volunteers, the mean half‐lives of disappearance were found to be between 4.4 and 5.7 h for FVIII:C and between 6 and 9.4 h for vWF [ 12–15]. It is therefore usually recommended that desmopressin is given with 8–12 h intervals if prolonged treatment is needed.…”

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confidence: 99%

Effect kinetics of desmopressin‐induced platelet retention in healthy volunteers treated with aspirin or placebo

et al. 2000

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Desmopressin is often used for haemostatic treatment in platelet dysfunction, but the effect kinetics of platelet responses and the mechanism of action are poorly known. This study aimed to determine the kinetics of platelet function responses induced by desmopressin in healthy volunteers treated with aspirin or placebo. Another aim was to correlate platelet responses to changes of von Willebrand factor (vWF) in plasma. We measured platelet function with a glass bead retention test, Ivy bleeding time, vWF:Ag and multimeric structure in plasma. Median baseline platelet retention was 12% (normal reference range 16-27%) during aspirin treatment and 18% during placebo. Median peak platelet retention after desmopressin was 33% during aspirin treatment and 34% during placebo. After about 3 h platelet function had returned to baseline. A second desmopressin dose after 3 h stimulated platelet retention to a similar extent as the first dose. There was no correlation between platelet responses and quantitative or qualitative changes of vWF in plasma. Platelet count did not change significantly. Thus, desmopressin's effect on platelet function lasts for about 3 h, but may be prolonged by a second dose immediately thereafter. These findings may have important clinical implications for patients with aspirin-induced platelet dysfunction undergoing surgery.

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“…First used in the intravenous form, an intranasal form is now commonly used due to its convenience and ease of administration [ 3, 4]. More recent studies report the efficacy of higher dose (300 μg) intranasal delivery [ 5–8]. The higher concentration of desmopressin (1.5 mg mL −1 ) that makes this dosing possible is available as Stimate® [Product prescribing information, 1998, Centeon L.L.C.].…”

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confidence: 99%

Adverse events during use of intranasal desmopressin acetate for haemophilia A and von Willebrand disease: a case report and review of 40 patients

et al. 2000

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We report our experience with the incidence of adverse events during the use of Stimate brand intranasal desmopressin acetate (IN DDAVP) for patients with haemophilia A (HA) or von Willebrand disease (vWD) after noting two severe adverse events in one adult patient. All patients with documented vWD (type 1 or 2 A) or haemophilia A (mild, moderate or symptomatic carrier) from the Emory Comprehensive Hemophilia Center who had IN DDAVP challenge testing or were using Stimate for treatment of bleeding were evaluated for adverse events by patient report or nursing observation of clinical signs and symptoms. Forty patients were studied. Sixty-eight per cent (27/40) experienced clinical signs and/or symptoms. The majority of these symptoms were mild, however several patients reported moderate to severe side-effects and one adult patient required medical intervention for symptomatic hyponatraemia. In our experience, two-thirds of patients tested experienced adverse signs and/or symptoms with the use of Stimate; considerably higher than that reported from preliminary results in the literature. Young age did not correlate positively with adverse reactions. Severe adverse events requiring medical intervention were rare, however symptoms such as moderate to severe headache, nausea, vomiting and weakness may necessitate evaluation for hyponatraemia. This is the first report of symptomatic hyponatraemia in an adult patient with recommended dosing of Stimate. Side-effects may be minimized if patients adhere to instructions regarding fluid intake and composition while using IN DDAVP.

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Comparative Study of Intranasal, Subcutaneous and Intravenous Administration of Desamino-D-Arginine Vasopressin (DDAVP)

Cited by 69 publications

References 24 publications

Lymphoma Metastasizing to the Pituitary: An Unusual Presentation of a Treatable Disease

Lymphoma Metastasizing to the Pituitary: An Unusual Presentation of a Treatable Disease

Effect kinetics of desmopressin‐induced platelet retention in healthy volunteers treated with aspirin or placebo

Adverse events during use of intranasal desmopressin acetate for haemophilia A and von Willebrand disease: a case report and review of 40 patients

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