
desmopressin

diabetis insipidus, bedd vetting, haemophilia eiii, voonn willebrand rogam, uyarnna rakthathile yooriyayude alavu enniva chikilsikkaan upayogikkunna marunnaan dedavp enna vyaapaaranaamathil vilkkunna desmopressin. haemophilia eiii, voonn willebrand rogangalil, ithu mithamayathum mithamayathumaaya kesukalkku maathrame upayogikkaavoo. ithu mookkilo sirayilo vaayilo naavinu keezhilo kuthivaykkaam.
thalavedana, vayarilakkam, rakthathile soodiyam kurayal ennivayaanu saadhaarana paarshwafalangal. rakthathile soodiyam kurayunnathu apasmaarathinu kaaranamakum. vrukkasambandhamaaya prashnangalo rakthathile soodiyam kuravo ullavaril ithu upayogikkaruthu. garbhakaalath ithu upayogikkunnathu surakshithamaanennu thonnunnu. shareerathinte ausmotic balance, rakthasammardha niyanthranam, vrukkayude pravartthanam, moothrathinte uthppaadanam kuraykkuka ennivayil punk vahikkunna hormon vaasopresinte synthetic analogaanith.
1978ll amerikkayil vaidyashaasthraparamaaya upayogathinaayi desmopressinu amgeekaaram labhichu. ithu lokaarogya samghadanayude avashya marunnukalude pattikayil ulppedunnu. ithu oru generic marunnayi labhyamaan.
medical upayogangal.
kidakka nanaykkunnu.
rathrikaala enurasis (bedd vetting) chikilsikkaan desmopressin upayogikkunnu. ithu saadhaaranayaayi desmopressin asattett roopathil vaayiloode nirddeshikkappedunnu. dii. dii. eiii. vii. pii edukkunna kuttikalkk aazhchayil 2.2 kuravu nananja raathrikal undu, koodaathe placeboyumaayi thaarathamyappeduthumbol thadassamillaathe urangaanulla saadhyatha 4.5 madangu kooduthalaanu.
noktooriya.
2017ll, effda amgeekritha desmopressinu noktturiya prasnangalulla muthirnnavarkk (moothramozhikkaan raathriyil unarendathundu) chila gunangalundu.
rakthasraavam sambandhicha vaikalyangal.
saadhaaranayaayi mithamayathum mithamayathumaaya type 1 voonn willebrand rogathinulla aadya chikitsa reethiyaanu desmopressin (dii. dii. eiii. vii. pii). gurutharamaaya rogathilo asaadhaaranamaaya ghadakam VIII ullavarilo ithu shupaarsha cheiyunnilla. type 2eiii, 2emm, allengil 2enn voonn willebrand rogathinte upayogakshamatha vyathyaasappettirikkunnu. 2bii, type 3 voonn willebrand rogangalil saadhaaranayaayi shupaarsha cheiyunnilla.
neriya haemophilia eiii yill maathrame desmopressin shupaarsha cheyyappedunnulloo. aaghaatham moolamulla rakthasraavathino sasthrakriya moolamulla rakthasraavathe thadayunnathino ithu upayogikkaam. haemophilia bii (factor ikes deficiency) allengil kadinamaaya haemophilia eiii ennivayude chikilsayil ithu falapradamalla. euremia moolamundaakunna rakthasraavathinum ithu upayogikkaam.
prameham insipidus.
pityoottari allengil hypothalamous vazhi yathaakramam sravam kurayukayo allengil ulppaadippikkappedukayo cheiyunna aparyapthamaaya alavil endogenous antiduritic hormon (adh) nuu pakaramaayi central diabetis insipidus (diii) chikilsayil desmopressin upayogikkunnu. vrukkakal kaaranam diabetis insipidus roganirnaya pravartthanatthilum ithu upayogikkunnu, dii yill ninnu central verthirichariyaan. nephrogenic dii chikilsikkunnathil desmopressin falapradamalla, athinaal oru positteev prathikaranam saadhaaranayaayi central dii yude soochanayaanu.
paarshwafalangal.
rund perr marikkukayum mattu ambathombathu perkku apasmaram sambhavikkukayum cheythathinetthudarnnu us drugg regulatormaar nassel sprekalil munnariyipp nalki. shareerathile sodiyathinte alavinte kuravaaya hyponetremia moolamaanu ithu sambhavichathu, koodaathe amerikkayile kuttikalil nassel spray inii upayogikkaan anumatiyilla. ennirunnaalum, vyakthi aarogyavaanaayirikkunnidi kaalam kuttikalil rathrikaala enurasis chikilsaykku desmopressin gulikakal surakshithamaanennu us drugg regulatormaar paranju.
kadinamaaya chharddiyum vayarilakkavum panii, panii, kadutha jaladosham enniva undaayal rogikal desmopressin kazhikkunnath nirtthanam. choodulla kaalaavasthayil desmopressin kazhikkunnathino kadinamaaya vyayaamam pinthudarunnathino rogikal valare jagrata paalikkanam, kaaranam eee avasthakal shareerathinte electrolytilum jala santhulithaavasthayilum sammarddam cheluthum.
oru shareeram jalathinteyum sodiyathinteyum santhulithaavastha nilanirthendathundu. sodiyathinte alavu valare kurravaanengil (hyponetremia)-onnukil vellam edukkunnathinte falamo uppinte alavu kurayunnathino-oru vyakthikk apasmaram undakam, angeyattatthe kesukalil marikkukayum cheyyaam.
pravartthana samvidaanam.
moothrathil ninnu puranthallappedunna vellathinte alavu parimithappedutthikkondu desmopressin pravartthikkunnu; athaayath, ithu oru antiduritic aanu. ithu vrukka shekharana vaahikayude thalatthil pravartthikkunnu, ithu vii 2 resepterukalumaayi bandhippikkunnu, ithu cytosolic vesikkilukal vazhi akwaporin chaanalukal shekharana vaahikayude appikkal membranilekku mattunnathinulla soochanayaanu. distal nephronil eee akwaporin chaanalukalude saannidhyam moothrathil ninnulla jalathinte punarnirjanam vardhippikkunnu, ithu nephronil ninnu basolaattaral membran chaanalukaliloode systemic sarkkuleshanilekku nishkriyamaayi veendum vitharanam cheyyappedunnu. vii2 resepteril pravartthikkunnathiloode endothelial koshangalil ninnu voonn willebrand ghadakam purathuvidunnathinum desmopressin uthejippikkunnu. ithu ghadakam VIII-yude endogenous alavu vardhippikkukayum haemophilia eyude chikilsayil ithu upayogapradamaakkukayum cheiyunnu.
recombinent vaasoprassinekkaal pathukkeyaanu desmopressin tharamthaazhthappedunnathu, ithinu idaykkide nalkendathu aavasyamaanu. koodaathe, ithu rakthasammardhathe kaaryamaayi baadikkunnilla, athesamayam vasopressin dhamanikalude rakthaathimardhathinu kaaranamakum. vasopressin aaktinte prakaashanatthe uthejippikkunnu, ithu rakthakkuzhalile alfa-1 resepterinte prathikaranasheshi parokshamaayi vardhippikkukayum rakthakkuzhalukalude tone rakthasammardhavum vardhippikkukayum cheiyunnu. niravadhi padanangal kaanikkunnath desmopressin aakt releasine uthejippikkunnil (cushings rogathilozhike), athinaal rakthasammardham nerittu uyarthunnilla, ennirunnaalum, aarogyamulla 50 sathamaanathiladhikam vishayangalil ithu aakt releasine uthejippikkunnuvennu oru patanam kaanikkunnu. koodaathe, ookru administreshanethudarnnathu saadhaarana vishayangalil aakt, courtisol release vardhippikkaan desmopressinu kazhiyum, pakshe anorexia nervosa ulla rogikalil allah.
rasathanthram.
onpathu amino aasidukal adangiya peptaidaaya saadhaarana manushya hormon arjinin vasopressin (antiduretic hormon allengil adh) yude synthetic roopamaanu desmopressin ("1-diamino-8-arjinin vasopressin").
vaasopresinumaayi thaarathamyappeduthumbol, desmopressinte aadyathe amino assid demainate cheyyappedukayum ettaam sthaanathulla arjinin "levo" roopathekkaal "dextro" yilaanu (stereochemistry kaanuka).