Diabetes insipidus : treatment
Endocrinology / / August 12, 2017
Those patients who developed diabetes insipidus due to a tumor or inflammation in dientsefalo-pituitary region, appropriate treatment of the underlying disease.
addition to the etiological treatment, these patients underwent substitution treatment administration of vasopressin preparations.Substitution therapy is the main treatment in patients with "idiopathic" diabetes insipidus.
most simple method of substitution therapy is the introduction into the nasal passages of a fine powder of the dried posterior pituitary - adiurecrine.
adiurecrine intranasal administration has antidiuretic action for about 8 hours, so the drug should be administered no less than 3 times a day.The initial dose adiurecrine appointment - 0.03.In case of an insufficient effect, the dose can be increased to 0.04-0.05 at reception.For those patients in whom the action adiurecrine saved less than 8 hours, the intervals between doses of the drug are reduced to 6 hours.
In the presence of acute or chronic inflammation of the nose
currently for the treatment of diabetes insipidus used oilsuspension tannatovoy salt vasopressin.1-5 units of this drug provides the antidiuretic effect (intramuscular injection) for 18-36 hours. In some patients with diabetes insipidus have seen a good effect in the application of sublingual tablets containing powder from the posterior pituitary.
In some patients, medications antidiuretic actions cause headaches, which, apparently, are not associated with hypertensive effect of vasopressin, and with brain swelling due to fluid retention.In rare cases, the introduction of these drugs are stomach pain due to increased tone of smooth muscles of the intestine.
adiurecrine and other posterior pituitary preparations can be applied to pregnant women suffering from diabetes insipidus.Apparently, oxytocin impurity contained in these preparations, had no significant effect on tonic uterus during normal pregnancy.With increased excitability of the uterus from these drugs is better to abstain.Such patients should preferably designate synthetic or vasopressin preparations use other types of therapy, including treatment with diuretics.
Diuretic drugs have a paradoxical effect on the diuresis and thirst in patients with diabetes insipidus, decreasing urine output by 50%.For the treatment can be applied to 1 ml merkuzal daily, chlorothiazide (1.0 per day, administered over 2-3 hours fractional) gipotiazid - 100 mg per day.
the treatment of strong diuretics should consider the possibility of hypokalemia, and long-term therapy is recommended the introduction of potassium salts.
mechanism of action of diuretics with diabetes insipidus is not installed.
In the literature there are indications of a beneficial effect in diabetes insipidus diathermy head.
- diabetes insipidus
- Nutrition and diet in diabetes: the main recommendations
- Type 1 diabetes (diabetes in children)
- fundus changes in diabetes
- Diabetic Foot: causes, symptoms, treatment
- diet in type 1 diabetes
- overdose of insulin
- pancreas Changes in the fundus in diabetes
- Gestational diabetes
flow forecast, disabled
in cases where diabetes insipidus developed in connection with the tumor, trauma or inflammation in dientsefalo-pituitary region, course, prognosis and ability to work depends on the dynamics of the underlying disease.
repeatedly been cases cure diabetes insipidus resulting from the inflammatory process - syphilis.
When "idiopathic" diabetes insipidus outlook on life is favorable, but recovery does not occur.Patients are forced to resort to lifetime replacement therapy.
Employability patients with diabetes insipidus, in which there are no other signs of dysfunction dientsefalo-pituitary system, depends on the effectiveness of substitution therapy.For those patients who vasopressin drugs can completely eliminate polyuria and thirst, disabled preserved.In those cases where the substitution therapy is not effective or the treatment of antidiuretic hormone preparations is difficult due to its side effects (headache), patients with limited ability to work.These patients can not carry out a series of works related to the constant contact with people or the uninterrupted control of a technological process (work on the assembly line, driving a vehicle, and so on. N.).