Medications to treat Diabetes InsipidusActive learning template: System Disorder STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Alterations in Health (Diagnosis) Pathophysiology Related to Client Problem Health Promotion and Disease Prevention ASSESSMENT SAFETY CONSIDERATIONS Risk Factors Expected Findings Laboratory Tests Diagnostic Procedures PATIENT-CENTERED CARE Complications Nursing Care Medications Client Education TherapeuticProcedures Interprofessional Care
The Correct Answer and Explanation is:
Medications to Treat Diabetes Insipidus (DI):
- Desmopressin (DDAVP): A synthetic analog of antidiuretic hormone (ADH), primarily used in central DI.
- Chlorpropamide: Sometimes used as adjunct therapy in central DI to increase ADH sensitivity.
- Thiazide Diuretics (e.g., hydrochlorothiazide): Used for nephrogenic DI to reduce polyuria.
- Indomethacin: A prostaglandin inhibitor that enhances renal response to ADH in nephrogenic DI.
- Amiloride: A potassium-sparing diuretic especially effective in lithium-induced nephrogenic DI.
Explanation (approx. 300 words): Diabetes Insipidus is a disorder characterized by the inability to concentrate urine due to inadequate production or renal response to antidiuretic hormone (ADH). It presents in two main forms: central (neurogenic) DI, resulting from decreased ADH secretion, and nephrogenic DI, caused by renal insensitivity to ADH.
In central DI, Desmopressin is the treatment of choice. It acts by mimicking natural ADH, allowing the kidneys to reabsorb water in the collecting ducts. Desmopressin is effective at reducing polyuria and excessive thirst and can be administered orally, intranasally, or via injection depending on patient needs. Chlorpropamide, a sulfonylurea, is sometimes used to potentiate the action of residual ADH and reduce urine output.
For nephrogenic DI, where ADH is produced but the kidneys fail to respond, therapy focuses on reducing urine volume and correcting electrolyte imbalances. Thiazide diuretics, paradoxically, reduce polyuria by causing mild volume depletion, leading to increased sodium and water reabsorption in the proximal tubule. This results in less water reaching the distal nephron, thereby decreasing urine output. Indomethacin inhibits prostaglandin synthesis, which can otherwise blunt the action of ADH, thereby enhancing the kidney’s concentrating ability. Amiloride is especially helpful in nephrogenic DI caused by chronic lithium use, as it blocks lithium uptake into the renal collecting duct cells.
Overall, the medication regimen is tailored to the type and cause of DI, with the goal of restoring fluid balance, preventing dehydration, and improving patient quality of life. This requires regular monitoring of electrolyte levels and patient symptoms to avoid complications such as hypernatremia.
