Severe hyponatremia caused by intranasal desmopressin for nocturnal enuresis

Kallio, Johanna; Rautava, Päivi; Huupponen, Risto; Korvenranta, Heikki

doi:10.1111/j.1651-2227.1993.tb12585.x

Cited by 10 publications

(5 citation statements)

References 13 publications

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“…Weinstein et al (15) report four cases of clinically significant hyponatraemia in children with underlying coagulopathies given prophylactic DDAVP before surgery in combination with the IV infusion of hypotonic solutions. In contrast with the case that we report, their cases each received multiple doses (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) of DDAVP.…”

Section: Discussioncontrasting

confidence: 59%

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Convulsions and respiratory arrest in association with desmopressin administration for the treatment of a bleeding tonsil in a child with borderline haemophilia

Francis

Leary

Niblett

1999

Acta Anaesthesiol Scand

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Section: Discussioncontrasting

confidence: 59%

“…We have reviewed the literature and identified 11 case reports of convulsions following DDAVP administration (6)(7)(8)(9)(10)(11)(12)(13)(14). Excess fluid intake was a contributory factor in 6 of the 11 cases.…”

Section: Discussionmentioning

confidence: 99%

Convulsions and respiratory arrest in association with desmopressin administration for the treatment of a bleeding tonsil in a child with borderline haemophilia

Francis

Leary

Niblett

1999

Acta Anaesthesiol Scand

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“…Some disclosed side-effects of the nasal spray form are nasal congestion, mild headache, rhinitis, and epistaxis whereas the tablet form has disclosed the side-effects of mild headache 20 . Very rare cases of hyponatremia secondary to water intoxication can also be seen 21,22 . Most of these cases occurred because of excessive fluid intake in combination with taking the medication.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Treatment and Management of Nocturnal Enuresis: A Review

Reddy¹,

Sripada²

2017

IJPCR

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Nocturnal Enuresis (NE) is the involuntary passing of urine whileasleep after the age at which bladder control would normally be prevised. NE has hassled humans for hundreds of years. It has been recognized since the time of Papyrus Ebers, 1550 B.C. Various potions were prepared by using different plants, animals or organs in some of the early treatment modalities. A number of medications have been used to treat nocturnal enuresis where, Imipramine and Desmopressin acetate were found to be efficacious. Besides, some credit has also been given to Oxybutynin. Because of the high relapse rates recited after short-term therapy with pharmacotherapeutic agents, pharmacological treatment for NE is best considered as management therapy rather than a cure. In this review article, we have mainly focused on the treatment and management of nocturnal enuresis by reviewing various treatment modalities along with behavioural modifications, bladder retention training, hypnotherapy, psychotherapy and combination therapy.

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“…1,3,10 Water intoxication with severe hyponatremia, sometimes associated with seizures and coma, has rarely been reported in association with intranasal desmopressin. [1][2][3]11 Most cases were reported in children, whereas only four cases have previously been described in adults. 1,[4][5][6] The patients were two males and two females; one was age 32, and the other three were age 29 years.…”

Section: Discussionmentioning

confidence: 99%

“…In most cases, seizures developed. [1][2][3][4] The once-nightly dosage of intranasal desmopressin is thought to be safe as it allows for an escape from the effect during the following day by compensatory polyuria. 12 However, the effect may last for up to 24 hours, especially in the young child, the infant, and the elderly, 10,13 and water intoxication may occur even after a single dose of the drug if adequate restriction of water intake is not adhered to, as happened in our patient.…”

Section: Discussionmentioning

confidence: 99%

Coma and Seizures due to Severe Hyponatremia and Water Intoxication in an Adult with Intranasal Desmopressin Therapy for Nocturnal Enuresis

Odeh

Oliven

2001

The Journal of Clinical Pharma

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Desmopressin, a synthetic analogue of the antidiuretic hormone, is an effective medication for primary nocturnal enuresis for both children and adults. Its safety is well established. Although it has a favorable side effect profile, because of its pharmacological effect, intranasal desmopressin can rarely induce water intoxication with profound hyponatremia if given without adequate restriction of water intake. The authors describe an adult patient with water intoxication and severe hyponatremia accompanied by loss of consciousness and seizures after 2-day intranasal administration of desmopressin. The present and the previously reported cases emphasize the need for greater awareness of the development of this serious and potentiallyfatal complication. In addition, to adjust the drug to the lowest required dosage, adequate restriction of water intake is recommended, and serum levels of sodium should be measured periodically to allow for early detection of water intoxication and hyponatremia.

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Severe hyponatremia caused by intranasal desmopressin for nocturnal enuresis

Cited by 10 publications

References 13 publications

Convulsions and respiratory arrest in association with desmopressin administration for the treatment of a bleeding tonsil in a child with borderline haemophilia

Convulsions and respiratory arrest in association with desmopressin administration for the treatment of a bleeding tonsil in a child with borderline haemophilia

Treatment and Management of Nocturnal Enuresis: A Review

Coma and Seizures due to Severe Hyponatremia and Water Intoxication in an Adult with Intranasal Desmopressin Therapy for Nocturnal Enuresis

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