DrPrashant June - 30 - 2010 antidiuretic drugs

by Teena Bhayal

Diabetes Incipidus-Definition:-

Diabetes Incipidus is a condition in which the kidneys are unable to conserve water.


  • Diabetes insipidus (DI) is an uncommon condition that occurs when the kidneys are unable to conserve water as they perform their function of filtering blood.
  • The amount of water conserved is controlled by antidiuretic hormone (ADH), also called vasopressin.
  • ADH is a hormone produced in hypothalamus. It is then stored and released from the pituitary gland, a small gland at the base of the brain.
  • Diabetes insipidus is  caused by a lack of ADH is called central diabetes insipidus.
  • When Diabetes insipidus is caused by a failure of the kidneys to respond to ADH, the condition is called   nephrogenic diabetes insipidus.
  • Central diabetes insipidus is caused by damage to the hypothalamus or pituitary gland as a

result of:

  • Head injury
  • Infection
  • Surgery
  • Tumor
  • Nephrogenic Diabetes insipidus involves a defect in the parts of the kidneys that reabsorb water back into the bloodstream. It occurs less often than central DI.
  • Nephrogenic DI may occur as an inherited disorder in which male children receive the abnormal gene that causes the disease from their mothers.
  • Nephrogenic DI may also be caused by:
  1. certain drugs (such as lithium, ampphotercin B and demeclocycline)
  1. b. kidney disease(such as polycystic kidney disease)


?   Excessive thirst

a.  May be intense or uncontrollable

b.  May involve a craving for ice water

?  Excessive urine volume.

Signs and Test:-

  1. MRI of head.
  2. Urine analysis
  3. Urine output


  • Central diabetes insipidus may be controlled with vasopressin (desmopressin, DDAVP)
  • as either a nasal spray or tablets.
  • Hereditary nephrogenic DI and lithium-induced nephrogenic DI are treated by drinking enough fluids to match urine output and with drugs that lower urine output.
  • Drugs used to treat nephrogenic DI include:
  • Anti-inflammatory medication (indomethacin)
  • Diuretics [hydrochlorothiazide (HCTZ) and amiloride-is drug of choice for lithium induced DI]
  • Hydrochlorothizide
  • Chlorpropamide-ORAL HYPOGLYCEMIC
  • Carbamazepime-is an antiepileptic

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