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Pre-reg > Anti-diuretic hormone disorders > Flashcards

Anti-diuretic hormone disorders Flashcards

1
Q

Examples of ADH disorders?

A

Diabetes insipidus
Syndrome of inappropriate ADH secretion

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2
Q

What is Diabetes Insipidus

A

When the body loses too much fluid by over urination.

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3
Q

what are the symptoms of Diabetes Insipidus

A

polyuria (passing large volumes of urine)
polydipsia (excessive thirst)

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4
Q

What are the two types of DI?

A

cranial
nephrogenic

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5
Q

what is cranial DI?

A

The body doesn’t make enough ADH (vasopressin) due to a problem with the hypothalamus or pituitary. (they are unable to regulate the synthesis of ADH)

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6
Q

what is nephrogenic DI?

A

Kidneys don’t respond to ADH (vaspopressin)

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7
Q

Treatment of cranial DI?

A

Desmopressin

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8
Q

Treatment of nephrogenic DI?

A

Thiazide like diuretics

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9
Q

types of thiazide diuretics?

A

bendroflumethiazide, chlorthalidone, and indapamide

(Thiazide can be used due to their paradoxical side effects of urinary retention)

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10
Q

MoA of desmopressin

A
  • Potent analogue of ADH (vasopressin), will cause the
    kidneys to make less/more concentrated urine
  • Has a longer duration of action than vasopressin
  • Does not have vasoconstriction effects like ADH, so will
    not increase BP
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11
Q

Use of Desompressin

A

Diabetes insipidus
Nocturnal enuresis
polyuria/polydipsia after surgery, hypophysectomy

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12
Q

Side effects of desmopressin

A

Hyponatraemia- can cause too much conservation of water leading to the dilution of sodium (hyponatraemia)

Oedema

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13
Q

Symptoms of hyponatraemia

A

headaches, N&V
and 3 C’s
coma, confusion and convulsion

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14
Q

Desmopressin- cautions

A

Hyponatraemia
elderly - increased risk of hyponatraemia and renal impairment
Antiepileptics- most cause Hyponatraemia

oedema- caution with conditions that are worsened with fluid retention
- Heart failure, hypertension and migraines

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15
Q

Desmopressin- contraindication

A

conditions which require diuretics
history of Hyponatraemia

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16
Q

Desmopressin- interactions

A
  • drugs that will increase ADH secretions - TCAs
  • drugs causing hyponatraemia- Diuretics, NSAIDs, SSRIs,
    Antiepileptics (sodium val and carbamazepine)
17
Q

What is the syndrome of inappropriate ADH secretion

A

Body releases too much ADH (vasopressin) therefore too much water is conserved. = dilution of sodium (hyponatraemia)

18
Q

Treatment of the syndrome of inappropriate ADH secretion

A

restrict fluid intake
Demeclocycline (tetracycline) - block effects of ADH
Tolvaptan (ADH receptor antagonist)

19
Q

Tolvaptan- Caution

A

fast correction of sodium imbalance can cause an influx of water into the cells.
This can damage myeline sheath of neurones and can cause fatal CNS complications.

Pre-reg (13 decks)

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