desmopressin dose for hyponatremia noroxin

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During the initial titration period and continued therapy, observe and monitor closely. A common compromise between these two concerns would be to use hypertonic saline, but at a low infusion rate.

Blood pressure and heart rate monitoring during infusion is recommended.

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The dose may be titrated up to 0.6 mg to achieve the desired response. Fluid restriction should be observed, and fluid intake should be limited to a minimum from 1 hour before Adjust morning and evening doses …

Desmopressin intranasal formulations are no longer indicated for the treatment of primary nocturnal enuresis due to the risk for developing severe hyponatremia that can result in seizures and death.The comparable antidiuretic dose of the injection is approximately 1/10 the intranasal dose.Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Drugs

The typical approach might be a slow infusion of 3% sodium chloride.

206996-overview

956447-overview 2010

Oral: 0.05 mg twice a day.

2002

Preoperative IV doses may be given 30 minutes prior to scheduled procedure.

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The presence of neurologic symptoms supports the use of hypertonic saline. IV and subcutaneously: No definitive dosing available.

Repeat administration should be determined by laboratory response as well as the clinical condition of the patient.IV: 0.3 mcg/kg once slowly over 15-30 minutes.

2002

The dose can be titrated up to 30 mcg once daily (or 30 mcg divided into two daily doses, typically with 20 mcg given in the morning and 10 mcg given at nighttime). encoded search term (desmopressin (DDAVP%2C Stimate)) and desmopressin (DDAVP, Stimate) Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery PatientsLate Dinner Affects Metabolism, May Lead to Weight Gain, DiabetesMetabolic Disease: Is It the Fat, Sugar, or Processed Food? https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvZGRhdnAtc3RpbWF0ZS1ub2N0aXZhLWRlc21vcHJlc3Npbi0zNDI4MTk= night following (24 hours after) the last intranasal dose.

We comply with the HONcode standard for trustworthy health information - If patients are receiving intranasal therapy, begin oral therapy 12 hours after the last intranasal dose. Applies to the following strengths: 0.15 mg/inh; 10 mcg/inh; 4 mcg/mL; 0.1 mg; 0.2 mg; 15 mcg/mL; 0.01%; 27.7 mcg; 55.3 mcg; 0.83 mcg/0.1 mL; 1.66 mcg/0.1 mLIV: 0.3 mcg/kg once slowly over 15-30 minutes. Nocturnal polyuria was defined in clinical trials as nighttime urine production exceeding one-third of 24-hour urine productionIndicated for patients with hemophilia A or von Willebrand disease (type 1) with Factor VIII coagulant activity levels >5%; will also stop bleeding in patients with episodes of spontaneous or trauma-induced injuries (eg, hemarthroses, intramuscular hematomas, mucosal bleeding)Fluid intake should be limited 1 hr prior to dose until the next morning or at least 8 hr after administrationRepeat use determined by clinical symptoms and laboratory valuesNocturnal polyuria was defined in clinical trials as nighttime urine production exceeding one-third of 24-hour urine productionIndicated for treatment of nocturia due to nocturnal polyuria in adults who awaken at least 2 times per night to void; nocturnal polyuria was defined in clinical trials as night-time urine production exceeding one-third of 24-hr urine production≥65 years: 0.83 mcg in either nostril ~ 30 min before going to bed; 0.83 mcg dose may have lower risk of hyponatremia; may be increased to 1 spray of 1.66 mcg after at least 7 days, if needed, provided serum sodium has remained normalA total of 562 subjects 65 years or older were enrolled in the clinical trials, ~48% of the study populationClinical studies of desmopressin have shown an increased risk of hyponatremia in patients ≥65 years compared to those <65 yearsModerate to severe renal impairment (CrCl <50 mL/min)Factor VIII levels <5% or presence of factor VIII antibodiesTherapeutic effect has not been observed in patients who have been febrile or stressed for several days; monitor for efficacy if necessaryUse caution in patients with habitual or psychogenic polydipsia (increased risk of hypnatremia)Risk of potentially fatal hyponatremia/seizures; may occur with any route of administrationAnaphylactic reactioins reported (rare) with IV and intranasal administrationUse alternative route of administration if changes in the nasal mucosa resulting from edema or scarring occursRapid IV infusions may result in severe hypotensionInterrupt therapy if patient perform activities associated with increase in water consumption or with acute illness including fever or recurrent vomiting or diarrheaUse with caution in patients predisposed to thrombus formation; acute myocardial infarction and cerebrovascular thrombosis reported with desmopressin injectionTherapy can cause fluid retention, which can worsen underlying conditions that are susceptible to volume status, including congestive heart failure (see Contraindications)In children and the elderly adjust fluid intake downward to decrease possibility of water intoxication and hyponatremiaProlonged experience with desmopressin in pregnant women over several decades, based on available published data and case reports, did not identify a drug associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; in addition, in vitro studies with human placenta demonstrate poor placental transfer of desmopressin; no adverse developmental outcomes were observed in animal reproduction studies with administration of desmopressin during organogenesis to pregnant rats and rabbits at doses approximately <1 and 38 times, respectively, the maximum recommended human dose based on body surface area (mg/m²)Not recommended for treatment of nocturia in pregnant women; nocturia is usually related to normal, physiologic changes during pregnancy that do not require treatmentDesmopressin is present in small amounts in human milk and is poorly absorbed orally by infantThere is no information on effects of desmopressin on breastfed infant or on milk production; development and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and potential adverse effects on breastfed infant from therapy or from the underlying maternal conditionA: Generally acceptable.

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The usual dosage range is 0.1 mg to 1.2 mg PO per day, given in 2 to 3 divided doses.

Blood pressure and heart rate monitoring during infusion is recommended.

and formulary information changes.

For pediatric patients 4 years of age and older, the recommended starting dosage of DDAVP Nasal Spray is 10 mcg once daily into one nostril. Some have suggested an initial dosage range of 0.1 to 1 mcg in 1 or 2 divided doses.

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