Drug of choice for central diabetes insipidus is
Desmopressin (dDAVP):- This synthetic peptide is a selective V2 agonist; but has negligible vasoconstrictor activity. It is also longer acting because enzymatic degradation is slow; t 1/2 1-2 hours; duration of action 8-12 hours. Desmopressin is the preparation of choice for all V2 receptor related indications. The intranasal route is preferred, though bioavailability is only 10-20%. Uses :- Based on V2 actions (Desmopressin is the drug of choice). 1. Diabetes insipidus DI of pituitary origin (neurogenic) is the most impoant indication for vasopressin. It is ineffective in renal (nephrogenic) DI, since kidney is unresponsive to ADH. Life- long therapy is required, except in some cases of head injury or neurosurgery, where DI occurs transiently. The dose of desmopressin is individualized by measuring 24 hour urine volume. It can be used in transient DI and to differentiate neurogenic from nephrogenic DI--urine volume is reduced and its osmolarity increased if DI is due to deficiency of ADH, but not when it is due to unresponsiveness of kidney to ADH. Ref:- kd tripathi; pg num:-596,597
Leuprolide
Insulin
Thiazide diuretics
Desmopressin
Kidney