Antidiuretic hormone disorders

Question 1

Which of the ADH analogues has the least pressor and antidiuretic effect?

Answer 1

Terlipressin

Question 2

Which of the ADH analogues is used in variceal bleeds?

Answer 2

Terlipressin (vasopressin itself can also be used)

Question 3

Advantages of demospressin over vasopressin in the use of diabetes insipidus ?

Answer 3

• Longer duration of action (less resistant to breakdown than vasopressin)
• More potent than vasopressin
• No vasoconstriction effect

Question 4

Name the types of Diabetes Insipdus

Answer 4

Neurogenic (cranial) - hypothalamus stops producing vasopressin
Nephrogenic- Kidneys unable to respond to vasopressin

Question 5

Why is the dose of desmopressin adjusted every 24 hours in the treatment of cranial diabetes insipidus?

Answer 5

To prevent water intoxications and allow slight diuresis

Question 6

SEs of desmopressin

Answer 6

Hyponatremia, nausea, headaches

Question 7

Methods of administration for desmopressin

Answer 7

Can be given IM, Intra-nasally, and orally

Question 8

Which ADH analogue can be used in obstetrics?

Answer 8

Oxytocin

Question 9

Which antiepileptic can be used in partial cranial DI?

Answer 9

Carbamazepine

Question 10

Which group of diuretics may be used to treat partial cranial DI and nephrogenic DI because of its paradoxical antidiuretic effects?

Answer 10

Thiazide-like diuretics

Question 11

1st line therapy for hyponatremia caused by SIADH?

Answer 11

Fluid restriction

Question 12

What drugs can be used in the treatment of SIADH if fluid restriction is unsuccessful?

Answer 12

Tolvaptan and Demeclocycline hydrochloride

Question 12

Which drug in the treatment of SIADH can cause severe neurological events due to osmotic demyelination?

Answer 12

Tolvaptan- if hynotraemia rapidly corrected

Question 13

ADH antagonist

Answer 13

Tolvaptan

Question 14

Tetracycline used in SIADH

Answer 14

Demeclocycline hydrochloride