Blood Clotting Disorder Bleeding Treatment Desmopressin

Desmopressin acetate is a synthetic hormone that can increase clotting capabilities in inpiduals with certain blood disorders. Some hemophiliacs and those diagnosed with von Willebrand’s disease may especially benefit from desmopressin treatment.

Along with treating blood disorders, desmopressin can also be used to:

  • enhance short-term memory
  • prevent diuretics from dehydrating the body
  • resolve bedwetting
  • treat diabetes insipidus, a condition causing excessive thirst and frequent urination.

The Clotting Process

Clotting occurs when certain elements in the blood respond to an injury. Among these factors are blood platelets with special proteins, known as “clotting factors.” When the body suffers some trauma, the mesh-like network of these thickening agents goes into action to prevent further damage from excessive bleeding.

One such agent is the von Willebrand factor, which transports Factor VIII and assists in platelet action where blood vessels have been injured. It works much like a fast-acting glue to provide a base for stopping the flow of blood.

When a person has lower than normal levels of one or both of these factors in his blood, he suffers from hemophilia A and/or von Willebrand’s disease. While hemophilia is a blood disorder that typically affects males, the latter affects both males and females. Neither of these conditions has a cure.

How Desmopressin Works

Desmopressin acetate is a substance made from the fabricated replication of “arginine vasopressin,” a naturally occurring hormone in the pituitary gland that regulates blood pressure and kidney function. It sends signals to control and constrict blood vessels when an injury occurs. Excessive bleeding can often create a dangerous drop in blood pressure, especially if clotting does not occur quickly.

While desmopressin is effective on the mildest form of von Willebrand’s disease (Type I) and hemophilia A, it isn’t a treatment option for those diagnosed with hemophilia B, which involves a Factor IX coagulation deficiency (rather than a Factor VII deficiency). Hemophilia A and von Willebrand Type I inpiduals produce some of the required coagulation, or clotting, factors, which the body stores but cannot physically activate.

How Effective is Demopressin?

Desmopressin acts as a release, forcing the inactive proteins that the body stores to form blood clots when necessary. Because the amount of stored factor proteins varies widely among patients, the effectiveness of desmopressin also fluctuates with inpidual cases.

Another factor that can influence the effectiveness of desmopressin is the frequency of use. For example, if a patient takes desmopressin too frequently, this synthetic hormone may become ineffective, as the body hasn’t had enough time between doses to replenish its stores of clotting factor proteins. As a result, sticking to the recommended dosage is essential to making desmopressin as effective as possible.

To determine the appropriate dose for patients, doctors perform tests to gauge how much factor protein naturally exists in an inpidual’s body. The next step is to determine how well the factor works. Because the results of these tests can fluctuate, doctors may repeat them over the course of a few weeks to get the most accurate readings. A rise in von Willebrand factor, for instance, might occur if the patient:

  • gets pregnant
  • starts a new or expanded exercise routine
  • suffers from an infection or illness
  • takes oral contraceptives.

Taking Desmopressin

Unlike medications that patients regularly take (i.e., heart medication, cholesterol-lowering medication, etc.), desmopressin is typically only administered when a patient has suffered an injury or is about to undergo a medical procedure.

Physicians typically administer desmopressin intravenously or as a nasal spray. The dosage will depend on the:

  • patient’s age
  • patient’s tolerance to this hormone
  • patient’s weight
  • type of procedure/injury.

Regardless of whether the patient needs more or less desmopressin, its effect is only temporary because demopressin is only meant to resolve the excess bleeding for the duration of a procedure or immediately after an injury has occurred. Some instances when hemophiliac patients, as well as those suffering from von Willebrand’s diseases, will receive desmopressin include occurrences of:

  • dental work
  • excessive bruising
  • heavy menstrual periods
  • mild bleeding in joints
  • nosebleeds
  • surgery.

However, keep in mind that desmopressin is not a viable treatment for excess bleeding or severe bodily trauma. In many cases, these instances require direct transfusions of donated human clotting products.

Desmopressin Side Effects

Desmopressin is not a derivative of blood products, which means there is no risk of transmitting an infectious disease. However, like most medications, desmopressin has some associated side effects, including:

  • abdominal cramping
  • fatigue
  • flushing of the neck and face
  • headache
  • increased blood pressure
  • nasal congestion
  • pulse rate increase
  • water retention
  • weight gain.

In most cases, these desmopressin side effects result if the dosage is too high. Consequently, these symptoms typically disappear once the dosage is lowered.

However, if symptoms persist once the dosage has been lowered or you start to experience symptoms of an allergic reaction to desmopressin (i.e., itchy rash, fever, etc.), contact your doctor or go to an emergency room immediately.

In rare instances, desmopressin can cause seizures. Because desmopressin reduces the body’s urine production, patients tend to retain water. When too much fluid is retained and not enough is expelled, patients can experience seizures. As a result, doctors recommend that all patients receiving desmopressin limit their intake of liquid so that they stay hydrated without over saturating themselves. Younger and older inpiduals are at an especially high risk of fluid retention.

Doctors will closely monitor the following types of patients, as they are at a higher risk of developing desmopressin complications:

  • children under 12 months of age
  • inpiduals with diseases such as cystic fibrosis, which create an electrolyte imbalance
  • those who have undergone heart bypass surgery
  • those with coronary artery disease.

Because desmopressin affects blood pressure, let your doctor know if you are currently taking any medications for hypertension. Doctors can still administer desmopressin to these patients, albeit under closer supervision.

The majority of inpiduals diagnosed with a bleeding disorder suffer from the milder forms of the disorders. Coagulation therapies can reduce and eliminate life-threatening situations for those who suffer from these lifelong conditions.

Resources

Encyclopedia of Children’s Health (n.d.). Coagulation Disorders. Retrieved September 21, 2007, from the HealthOfChildren.com Web site: http://www.healthofchildren.com/C/Coagulation-Disorders.html.

Mayo Foundation for Medical Education and Research (2007). Hemophilia: Treatment. Retrieved September 21, 2007, from the MayoClinic.com Web site: http://www.mayoclinic.com/health/hemophilia/DS00218/DSECTION=7.

National Hemophilia Foundation (n.d.). What is von Willebrand disease? Retrieved September 21, 2007, from the Hemophila.org Web site: http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=182