DDAVP

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DDAVP

- 1-deamino, 8 D-arginine vasopressin.
- synthetic analogue of vasopressin

Haemostatic effects

- alters coagulation by an effect on vascular endothelium and platelets.
- useful in patients with haemophilia A, von Willebrand's and uraemia
- reduces post-operative haemorrhage and transfusion requirements in cardiac surgery patients
- likely that DDAVP will become established as having a general role in non-specifically improving haemostasis in selected surgical procedures and in some circumstances used in combination with an anti-fibrinolytic agent
- adverse effects include a decrease in free water clearance, hypotension or hypertension and thrombosis
- dose 8 mcg over 1 h. For patients with Von Willebrand’s disease give 0.3 m g/kg immediately before surgery

Hormonal effects

- larger doses sometimes required in very early phase of central DI. Possibly due to receptor blockade by biologically active precursors of ADH released by acutely damaged hypothalamic-pituitary tract.

Adverse effects

- doubts over safety in pregnancy

Reference

Donaldson MDJ, Seaman MJ and Park GR, Massive blood transfusion. Br J Anaesth 1992; 69:621-30
Isbister JP, Blood transfusion, blood products, and autologous transfusion. Current Opinion in Anaesthesiology 1992, 5:263-71

©Charles Gomersall, October, 2009 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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