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Vasopressin Rx diabetes insipidus

Diabetes insipidus is due to either inability to produce ADH or kidney not responding to ADH. DI results in polyuria with increased serum osmolarity. Pre-op treatment includes replacing daily fluid loss, nasal administration of DDAVP (Desmopressin), or IV ADH (Vasopressin) w/ infusion allowing daily break-through polyuria. Measure serum Osms hourly, if > 290 give hypotonic fluid. If ADH deficiency is only partial its not necessary to give IV ADH unless Osms > 290.

In general, DDAVP is preferred over vasopressin as DDAVP does not produce systemic hypertension.