Antidiuretic Hormone Disorder

Question 1

what is diabetes insipidus

Answer 1

excess dilute urine = extreme thirst

Question 2

normal

how is concentrated urine produced

Answer 2

-hypothalamus produces vasopressin (ADH) + stores in pituiltary gland
-ADH is release when H20 in body is too low
-ADH retains H20 in body by reducing H20 lost in kidneys
= concentration urine

Question 3

how is dilute urine produced in diabetes insipidus

Answer 3

-reduced prod of ADH
-kidneys don’t retain as much water
-too much water released from body causing extreme thirst/polyuria
-more dilute urine

Question 4

how do you tx lack of vasopressin

Answer 4

with vasopressin or desmopressin

Question 5

how do you tx if kidneys dont respond to ADH

Answer 5

Thiazide diuretic

Question 6

what effect does thiazide diuretic have?

Answer 6

paradoxical effect = opposite to normal

Question 7

which one is more potent desomopressin or vasopressin?

Answer 7

desomopressin

Question 8

advantage of desomopressin

Answer 8

no vasocontrictor effect

Question 9

s/e of desomopressin

Answer 9

hyponatraemia
nausea

Question 10

high ADH lvl

inappropriate ADH production

Answer 10

-high ADH
-body stores too much water
-dilutes salt conc in blood
= causes hyponatraemia

Question 11

tx of inappropriate ADH secretion

Answer 11

-fluid retention
-demeclocycline (blocks renal tubular effect of ADH)
-tolvaptan (vasopressin antagonist)

Question 12

why shouldn’t tolvaptan be used rapidly to correct hyponatraemia?

Answer 12

can cause osmotic demyelination
-serious neurological events