What medicine is better for diabetes insipidus

Patients with diabetes insipidus need timely treatment because this disease can cause varying degrees of damage to the patient's glomeruli. Mild cases can be treated with some medications. Medication needs to be selected according to the progression of the disease and physical condition.

(I) Aqueous vasopressin

Diabetes insipidus can be treated with hormone replacement therapy. Oral vasopressin is ineffective. 5-10U of aqueous vasopressin is injected subcutaneously, and its effect can last for 3-6 hours. This preparation is often used for the initial treatment of delirious patients with diabetes insipidus secondary to brain trauma or neurosurgery. Because of its short-acting effect, it can identify the recovery of neurohypophysial function and prevent water intoxication in patients who are close to intravenous infusion.

(ii) Powder for diabetes insipidus

Lysine vasopressin is a nasal spray that produces an antidiuretic effect for 4 to 6 hours after a single application. In case of respiratory tract infection or allergic rhinitis, the nasal mucosa becomes edematous, which reduces the absorption of such drugs. In such cases and in unconscious patients with diabetes insipidus, desmopressin should be given subcutaneously.

(III) Long-acting diabetes insipidus

Long-acting vasopressin is a tannic acid vasopressin preparation containing 5U per milliliter. Starting from 0.1ml, it can be gradually increased to 0.5-0.7ml/time according to the daily urine volume. One injection can last for 3-5 days and is injected deep into the muscle. Mix thoroughly before injection to avoid excessive dosage which may cause water intoxication.

(IV) Synthetic DDAVP (1-deamino-8-dextrorotatory-arginine vasopressin)

DDAVP increases the antidiuretic effect while the vasoconstrictive effect is only 1/400 of AVP. The ratio of antidiuretic to pressor effect is 4000:1, and the action time is 12 to 24 hours. It is currently the most ideal antidiuretic. 1-4 μg subcutaneous injection or 10-20 μg intranasal administration has an antidiuretic effect for 12-24 hours in most patients.

(V) Other oral medications

Patients with diabetes insipidus who have residual AVP release may respond to certain oral nonhormonal agents. Chlorpropamide can stimulate the pituitary gland to release AVP and enhance the effect of AVP on the renal tubules, which may increase the formation of tubular cAMP, but it is ineffective for nephrogenic diabetes insipidus. 200-500 mg, once a day, can have an antidiuretic effect. It starts working a few hours after absorption and can last up to 24 hours. Chlorpropamide can restore the sense of thirst and has a certain effect on patients with lack of thirst. This medicine has a certain blood sugar lowering effect, but eating on time can avoid hypoglycemia. Other side effects include liver cell damage and leukopenia. The mechanism of antidiuretic action of hydrochlorothiazide is unknown. The initial effect is salt diuresis, causing mild salt loss, a decrease in extracellular fluid, and increased water reabsorption by the proximal tubule, which reduces the initial urine volume entering the distal tubule. The exact mechanism is unknown. It is also effective for nephrogenic diabetes insipidus and can reduce urine volume by about 50%. It has a synergistic effect when used with chlorsulfuronamide. The dosage is 50-100 mg/d, taken in divided doses. When taking the medicine, you should eat a low-salt diet and avoid drinking coffee and cocoa-based foods. Clofibrate can stimulate the release of AVP and can also be used to treat diabetes insipidus. 100-500 mg, 3-4 times a day. Side effects include liver damage, myositis and gastrointestinal reactions. Amidopyrazine can also produce an antidiuretic effect by stimulating the release of AVP, and 400 to 600 mg per day is effective. However, this has other toxic side effects and is not widely used.