diabetes insipidus

• Diabetes insipidus is the damage of the posterior pituitary gland leading to deficiency in production of antidiuretic hormone. and it is characterised by large amounts of dilute urine, usually >2.5 liter daily
• causes include: head trauma, neurosurgery and idiopathic
• general measure include: rehydration with water or rehydration with hypotonic fluids
• medicine treatment for postoperative or acutely ill patients: 1)desmopressin,IV/SC,2-4 mcg daily. OR 2)desmopressin,nasal spray,10-40mcg daily or 2-3 divided doses. OR 3)desmopressin,oral,0.05 mg,8-12 hourly.Optimal dose is 0,1-0,8 mg daily. 4)maximum dose is 1.2 mg daily
• medicine treatment for normal thirst mechanism or patient who does not receive IV fluids for other purposes: GIVE SAME DOSES AS POSTOPERATIVE and maintain urine concentration at 450-600 mOsm/kg
• medicine treatment for patient with abnormal thirst mechanism: desmopressin,IV,2-4mcg daily. always adjust level of antidiuresis(agent that reduces the output of urine) to maintain hydration and sodium plasma
• replacement therapy include: 1)desmopressin,nasal spray,10-40 mcg daily OR 2)desmopressin,oral,0.05 mg. optimal dose 0.1-0.8 mg daily. max dose is 1.2 mg daily