Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01185 (vasopressin)
 23,126 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1-Deamino-8-D-arginine vasopressin (DDAVP, desmopressin), a synthetic analog of the antidiuretic hormone L-arginine vasopressin, improves hemostasis parameters in cirrhotic patients. Hence its use in combination with a vasoactive drug such as terlipressin might improve the performance of this drug in controlling variceal bleeding. The aim of this trial was to compare the efficacy of desmopressin plus terlipressin with that of terlipressin alone in controlling acute variceal hemorrhage. Cirrhotic patients with active variceal hemorrhage diagnosed endoscopically were randomized within 2 hr of admission to receive desmopressin plus terlipressin or placebo plus terlipressin. Terlipressin (2 mg, intravenous bolus) was given at time 0 and every 4 hr thereafter for 24 hr. Desmopressin (0.3 microgram/kg, intravenously) or placebo was given in saline solution over 30 min at time 0 and at 26 hr. Patients were monitored for 24 hr after cessation of treatment. Treatment failure was defined as recurrence of active bleeding during treatment or within the 24 hr after treatment. After enrolling 51 of the planned 84 patients, we carried out an interim analysis. Treatment failure occurred in 13 of 24 patients randomized to receive desmopressin plus terlipressin (54.2%) and in 6 of 22 patients randomized to receive terlipressin (27.3%) (p = 0.06, Fisher's exact test). The trial was interrupted at this stage because patients treated with the "new" therapy fared worse than those treated with the standard therapy, and the possibility of reversing this trend by completing the trial was deemed remote. The addition of desmopressin does not improve and may worsen the efficacy of terlipressin in controlling acute variceal bleeding in cirrhotic patients.
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PMID:Randomized controlled trial of desmopressin plus terlipressin vs. terlipressin alone for the treatment of acute variceal hemorrhage in cirrhotic patients: a multicenter, double-blind study. New Italian Endoscopic Club. 822 14

Aspirin induces a haemorrhagic diathesis that persists for at least 1 week after discontinuation of the drug. The effect of the vasopressin analogue desmopressin was studied in 12 patients treated with aspirin who were undergoing cholecystectomy. Desmopressin was given to six of these patients. There were five postoperative bleeding complications; all occurred in patients who had not received desmopressin (P < 0.05). The bleeding time was prolonged in aspirin-treated patients and normalized by desmopressin (P < 0.05). Desmopressin can be used safely to prevent bleeding induced by aspirin.
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PMID:Use of desmopressin to prevent bleeding complications in patients treated with aspirin. 833 Jan 56

von Willebrand's disease (vWD) is the most frequent inherited disorder and is the result of a deficiency and/or abnormality of von Willebrand factor (vWF). As a consequence, the level of factor VIII, the presence of which reflects the ability of vWF to stabilise it, is usually low. Bleeding time, which reflects the ability of vWF to promote platelet adhesion to subendothelium, is therefore prolonged. However, from a therapeutic point of view, it appears that the correction of factor VIII and bleeding time is sufficient to prevent or treat bleeding in these patients. There are 2 main therapeutic tools to improve or normalise these major determinants of the bleeding tendency in this disorder. The majority of patients, identified by a test infusion, can be successfully treated by giving desmopressin (DDAVP), a synthetic analogue of vasopressin. Desmopressin is able to induce the increase of autologous vWF released from endothelial cells, leading to the correction of factor VIII levels and of bleeding time. In the remaining cases, blood products, namely factor/vWF concentrates, are required to accomplish haemostasis. All these concentrates are able to correct factor VIII levels, whereas their effect on bleeding time may not be consistent. The modern virucidal techniques abolish the risk of transmission of blood-borne viruses (e.g. hepatitis viruses and HIV) and make these products safer than blood-bank cryoprecipitate.
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PMID:Current management of von Willebrand's disease. 853 49

We have previously reported that vasopressin (AVP) V2 receptor stimulation increased renal blood flow in dogs anesthetized with pentobarbital. In this study, we examined the direct effects of AVP on afferent arterioles to clarify the role played by V2 receptors in regulating afferent arteriolar tone. We microdissected a superficial afferent arteriole with glomerulus from the kidney of a New Zealand White rabbit. Each afferent arteriole was cannulated with a pipette system and microperfused in vitro at 60 mm Hg. The effects of vasoactive substances were evaluated by changes in the lumen diameter of afferent arterioles. We found that AVP decreased the lumen diameter of microperfused afferent arterioles dose-dependently and that a V1 antagonist, OPC21268, inhibited the vasoconstrictor action of AVP. However, AVP 10(-8) M increased the lumen diameter of norepinephrine (NE)-constricted afferent arterioles pretreated with OPC21268 (OPC + NE, 8.2 +/- 0.7 microns; OPC + NE + AVP, 9.9 +/- 0.9 microns*; *P < 0.05, N = 13). This vasodilatory effect of AVP was abolished by pretreatment with a V2 antagonist, OPC31260. Desmopressin (dDAVP), a V2 agonist, increased the lumen diameter of the NE-constricted afferent arterioles (NE, 7.4 +/- 0.9 microns; NE + dDAVP, 10.1 +/- 0.7 microns*; *P < 0.05, N = 9). These results suggest that AVP V2 receptors are present in rabbit afferent arterioles and that V2 receptor stimulation induces vasodilation in rabbit afferent arterioles.
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PMID:Vasodilation induced by vasopressin V2 receptor stimulation in afferent arterioles. 864 13

Desmopressin is a commonly used, well-tolerated agent for the treatment of primary nocturnal enuresis and central diabetes insipidus. Intranasal desmopressin provides symptomatic relief with few serious complications. A 29-year-old woman with a long history of primary nocturnal enuresis began treatment with intranasal desmopressin. Although the enuresis ceased, she developed throbbing headaches, nausea, vomiting, paresthesia, lethargy, fatigue, and altered mental status over the next 7 days. When she came to the emergency room her sodium concentration was 127 mmol/L. The history of desmopressin use was not obtained at that time. She was treated with intravenous fluids and discharged. The symptoms returned and worsened over the next 4 days, and she returned to the emergency room stuporous. A repeat sodium was 124 mmol/L, and she was admitted. The history of desmopressin use was still not available. Medical evaluations included computerized tomography, lumbar puncture, complete blood counts, serum chemistries, and serologies. The next morning the woman was improved and informed clinicians of her desmopressin use. Without other causes for the hyponatremia, she was diagnosed with the syndrome of inappropriate antidiuretic hormone, presumably caused by desmopressin. Within 24 hours of fluid restriction and cessation of desmopressin, her symptoms and hyponatremia resolved. A review of the literature found 11 children and 2 adults in whom intranasal desmopressin was associated with hyponatremia, all of whom experienced seizures or altered mental status. Our patient illustrates the importance of early recognition and treatment of hyponatremia before the onset of seizures. When vague symptoms develop during desmopressin therapy, hyponatremia must be considered as part of the differential diagnosis. It may also be prudent to screen for electrolyte abnormalities in patients taking this agent to prevent serious iatrogenic complications.
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PMID:Intranasal desmopressin-induced hyponatremia. 888 98

Desmopressin is a synthetic analog of vasopressin used to promote hemostasis and reduce postoperative blood loss. Recent studies have shown that desmopressin decreases arterial blood pressure in the anesthetized rat and relaxes isolated segments of aorta and pulmonary artery. Responses to a clinical preparation of desmopressin were investigated in the hindquarters vascular bed of the cat under constant flow conditions so that changes in perfusion pressure directly reflect changes in vascular resistance. Responses to desmopressin and its vehicle, and the effect of receptor antagonists, inhibitors of prostaglandin, and nitric oxide synthesis inhibitors, were investigated.
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PMID:Vasodilator responses to desmopressin and its diluent, chlorobutanol, in the hindquarters vascular bed of the cat. 886 79

Desmopressin (1-deamino-8-D-argininevasopressin, DDAVP) is a synthetic analog of the antidiuretic hormone L-argininevasopressin. DDAVP has been shown to increase the plasma concentration of endothelial factor VIII, thus increasing coagulant activity. There is evidence from controlled clinical trials indicating that DDAVP can reduce blood loss and transfusion requirements for individuals with normal coagulation profiles undergoing various surgical procedures. This study was conducted to evaluate the efficacy of the DDAVP in reduction of blood loss during orthognathic surgery. Twenty patients, 15 females and 5 males, undergoing bimaxillary osteotomy were randomized into two groups of ten. Perioperatively, group 1 patients received 20 micrograms of DDAVP infused over one-half hour. Group II patients did not receive DDAVP. Hypotensive anesthesia (mean arterial pressure < 60 mm Hg) was routinely employed for both groups. On average, the blood loss in group I patients was 144 ml less per patient than group II patients (p < 0.50). Only 2 of 10 patients in group I lost in excess of 750 ml, while 6 to 10 group II patients experienced blood loss greater than 750 ml (p < 0.20). The average postoperative hematocrit for patients in group I dropped by 6.17 of the preoperative mean hematocrit (p < 0.001). The average drop in hematocrits among the group II patients was 11.61 (p < 0.001). When collated, this hematocrit drop of 11.61 for group II and 6.17 for group I (recipients of DDAVP) proved to be significantly different (p < 0.01). It is concluded from this study that patients receiving a standard dose of DDAVP prior to bimaxillary osteotomy would experience reduced intraoperative blood loss, providing that blood pressure is well controlled and fluid replacement is carefully managed. No significant adverse side effects of desmopressin acetate were observed.
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PMID:The role of DDAVP (desmopressin) in orthognathic surgery. 893 5

Desmopressin is a synthetic analog of the peptide hormone vasopressin in which the N-terminal alpha-amino group has been removed and L-arginine in position 8 has been replaced by D-arginine. Using 1H-NMR spectroscopy, we show that desmopressin binds to neurophysin-II, whereas deamino-vasopressin does not bind. Thus, the change in configuration at Arg8 causes a significant difference in the binding of these hormones to neurophysin-II. We have determined the structure of desmopressin bound to neurophysin-II using two-dimensional 1H nuclear magnetic resonance-transferred nuclear Overhauser effect techniques. A common binding motif for vasopressin and desmopressin is proposed that includes a positive charge group along with the hydrophobic surface formed by the side chains of Tyr2 and a beta-methylene provided by Phe-3. In vasopressin, the positive charge is provided by the N-terminal NH3+, whereas in desmopressin, the side chain of Arg-8 contributes the positive charge. The type II beta-turn found in residues Cys6-Pro7-D-Arg8-Gly9 of the bound structure of desmopressin folds the Arg8 side chain back toward the disulfide-bond loop, which allows the positive charged side chain of Arg8 to participate in binding. Such a type II beta-turn is not found in deamino-vasopressin in the presence of neurophysin-II.
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PMID:Differential binding of desmopressin and vasopressin to neurophysin-II. 894 Jan 42

Brain natriuretic peptide (BNP) messenger RNA was measured with a semiquantitative method from heart auricles and ventricles of vasopressin-deficient Brattleboro rats (DI) and from desmopressin treated Brattleboro rats (DI + DDAVP). Desmopressin had been injected peripherally and Long-Evans rats (LE) served as controls. The 3-day substitution treatment had shifted the fluid balance of DI almost to that of LE. In the present study, the amount of BNP mRNA, normalized to the glyceraldehyde-3-phosphate dehydrogenase mRNA content, was constant in all three groups in the right auricle. No changes were when the right auricular and left auricular mRNA levels were compared within each group. In the left auricle, desmopressin treatment increased significantly (P < 0.05) the amount of BNP mRNA compared with that of LE rats (from 1.09 +/- 0.21, n = 7 to 1.72 +/- 0.17, n = 8, arbitrary units). In all groups, the left ventricle had significantly (P < 0.05) higher mRNA content than the right ventricle (LE: 2.24 +/- 0.23 vs. 0.67 +/- 0.13, n = 6; DI: 2.30 +/- 0.60 vs. 0.33 +/- 0.05, n = 8; DI + DDAVP: 2.36 +/- 0.29 vs. 0.37 +/- 0.07, n = 10). In the right ventricle, both DI and DI + DDAVP rats had significantly (P < 0.05) lower mRNA content than LE rats (0.33 +/- 0.5 vs. 0.67 +/- 0.13 and 0.37 +/- 0.07 vs. 0.67 +/- 0.13, respectively). To conclude, these findings suggest that brain natriuretic peptide gene expression dissociates from, or rapidly adapts to, the chronic effects of peripheral desmopressin treatment which have shifted the fluid balance to almost normal in Brattleboro rats. The left ventricular pressure appears to regulate the brain natriuretic peptide gene expression.
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PMID:Brain natriuretic peptide (BNP) gene expression in the heart of vasopressin-deficient Brattleboro rats. 907 57

Peri-operative bleeding is associated with invasive surgery and has traditionally been compensated for by blood transfusion. Concerns about the risk of transfusion-transmitted disease have led to an increasing interest in synthetic haemostatic agents. Desmopressin (1-deamino-8-D-arginine vasopressin), a synthetic analogue of vasopressin, has been shown to be of benefit in the peri-operative management of von Willebrand's disease or mild haemophilia A. This paper addresses the role of desmopressin and bleeding during invasive surgery, particularly during cardiopulmonary bypass. Clinical trials using desmopressin in open cardiac surgery indicate that it may reduce blood loss in those with an excessive bleeding tendency. However, it is difficult to identify this group pre-operatively.
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PMID:Desmopressin and bleeding during invasive surgery. 908 35


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