Medications for antidiuretic hormone (ADH) disorders: Nursing Pharmacology

Antidiuretic hormone, or ADH for short, is the primary hormone that regulates fluid balance in the body, and is normally produced by the hypothalamus and stored in the posterior pituitary, which are both located within the brain.

Now, ADH disorders arise when the pituitary releases too much or too little of it. These disorders include diabetes insipidus, which results from a decrease in ADH; and syndrome of inappropriate ADH secretion, or SIADH for short, which results from an increased secretion of ADH.

Okay, so on one end of the spectrum, there’s ADH deficiency, which causes diabetes insipidus. This disorder is treated with ADH replacement therapy, which involves medications like vasopressin, which is a synthetic form of ADH, and desmopressin, which is a vasopressin analogue.

Both medications can be administered subcutaneously. In addition, vasopressin can be administered intramuscularly, and desmopressin can be administered orally, intranasally, or intravenously.

Once administered, these medications act on the kidneys by mimicking the actions of ADH, ultimately promoting the reabsorption of water at the distal convoluted tubule and collecting duct.

Now, these medications may cause side effects like headache, lethargy, and flushing. Other important side effects include nausea, vomiting, heartburn, and abdominal cramps.

In addition, clients who take vasopressin may present with urticaria and vertigo. These medications also cause vasoconstriction, resulting in cardiovascular side effects. Clients on vasopressin may experience chest pain, and even myocardial infarction.