Uropres

The intranasal agent Uropres belongs to the group of analogues of vasopressin - hormonal drugs of systemic exposure.

Indications of the uropreza

Assigned Uropres to reduce the daily outflow of urine:

• with diabetes insipidus of central origin;
• with an increase in diuresis due to trauma, provided a transient deficiency or lack of an antidiuretic hormone after removal of the pituitary gland;
• after surgery in the area of the pituitary;
• after traumatic brain injury.

Uropres is also used as an express diagnostic for determining the concentration properties of the kidneys, as well as for differentiating diabetes insipidus.

Release form

Uropres is an intranasal drop based on desmopressin. Drops have the appearance of a transparent liquid without a certain color and odor. With thorough mixing, the formation of visible foam on the surface, which settles for half an hour, is typical.

Uropres is packaged in 2.5 or 5 ml bottles, packed in a cardboard box.

Pharmacodynamics

Uropres is manufactured on the basis of desmopressin, a structural analog of the natural hormonal substance L-arginine-vasopressin.

Uropres increases the permeability of the epithelium of the distal segments of the renal tubules and accelerates the reverse absorption of water. At the same time, the amount of urinary fluid released decreases, its osmolarity increases, but the osmolality in the blood serum decreases. As a result of these processes, approaches to urination become less frequent, especially at night.

The effect of reducing the outflow of urine after the administration of Uropres in the amount of 10-20 μg can last from eight to twelve hours.

Pharmacokinetics

Biological availability Uropres after injection into the nasal cavity is approximately 3-5%. Noticeable concentration indices of the active ingredient in the serum are detected after 15-30 minutes. The concentration limit is observed after 60 minutes, but this figure may depend on the used dosage of the drug.

The distribution volume is estimated at 0.2-0.3 l / kg.

The active ingredient Uropres does not cross the blood-brain barrier.

The half-life after the introduction of Uropres in the nasal cavity can last from two to three hours.

A small amount of the active ingredient undergoes hepatic metabolism.

Dosing and administration

Uropres can be used only by intranasal application. Before applying drops on the mucosa, it is necessary to clean the nasal passages.

One drop of Uropres contains 5 μg of the active ingredient.

• For patients with diabetes insipidus, with polyuria after trauma, and with a pathological thirst of central origin, the amount of Uropres is selected individually. The optimal dose is from 10 to 20 mcg up to 2 times a day. In childhood (over 12 months), a single dosage is 10 μg up to 2 times a day. If during the treatment period there are signs of fluid retention in the tissues, then Uropres is temporarily canceled until the dosage is completely corrected.
• To carry out express diagnostics adhere to such dosages:
  • adult patients - 40 mcg;
  • Children of the first year of life - 10 mcg;
  • children over 12 months. - 20 mcg.

Express diagnostics is prescribed in order to differentiate diabetes insipidus and polyuria cider, or in order to evaluate the concentration renal function, which can be disrupted in connection with infectious pathologies of the urinary system. In addition, this diagnostic method can be used in the early stages of tubulointerstitial pathology - for example, when afflicted with lithium-based medicines, anesthetics, chemotherapy agents or immunosuppressors.

Express diagnostics are most often conducted in the morning. For twelve hours after the procedure, it is important to limit the patient's drinking regimen. For children under the age of five and for patients with high blood pressure or coronary diseases, fluid intake is cut by 50%.

Before the start of the rapid diagnostic procedure, the osmotic concentration of urinary fluid is necessarily assessed. After the administration of Uropres, two urine samples are collected (for example, 2 and 4 hours later). The "first" urine, which is collected during the first hour, pours out. The remaining two samples determine the osmotic concentration.

Small indicators, lack of growth or a slight increase in the indices indicate a disordered concentration of the kidneys. If, however, the osmotic concentration increases to a large extent and the amount of urine decreases, this may mean that an increase in daily diuresis is related to diabetes insipidus of central origin.

[1]

Use of the uropreza during pregnancy

Clinical testing of Uropres, which was conducted in pregnant and lactating women, found no adverse effects on a woman or a baby. Thus, Uropres is allowed to be used with a period of gestation as a substitute drug with a deficiency of antidiuretic hormone.

Only a small amount of Uropres is found in breast milk. This amount is not enough to affect in any way the amount of urination in an infant.

Contraindications

It is necessary to avoid the use of Uropres:

• with a tendency to an allergic response of the patient's body;
• with initial or psychogenic pathological thirst, with "alcoholic polydipsia";
• in severe stages of von Willebrand disease (2b), with reduced activity of the eighth factor to 5%, and also with the available antibodies to the factor "eight";
• with insufficient cardiac activity, or other conditions that must be accompanied by increased urine output;
• with moderate or significant failure of renal function (with creatinine clearance less than 50 ml per minute);
• with the syndrome of abnormal production of antidiuretic hormone;
• with hyponatremia.

Side effects of the uropreza

Overabundance of the used liquid can become the reason of a hyperhydration which is shown by such signs:

• weight gain;
• reduction of sodium in the blood;
• convulsions;
• a disorder of consciousness.

The listed picture is often observed in infants younger than 1 year old, or in old age.

Other side effects when using Uropres can be:

• increased blood pressure, hot flashes, stenocardia attacks;
• pain in the head, brain edema, disorders of consciousness, hyponatremic convulsions;
• obstruction of nasal breathing, runny nose, nose mucous bleeding, thirst;
• dyspepsia;
• hyperhidrosis;
• allergic manifestations (rash, bronchospasm, pruritus, febrile condition, anaphylactic shock).

In isolated cases, emotional disturbances were registered in patients of childhood.

After correcting the dosage of Uropres, the side effects tend to go away: allergic reactions are an exception.

Overdose

Signs of an overdose of Uropres can be:

• weight gain associated with edema;
• pain in the head;
• nausea;
• slight increase in blood pressure;
• increased heart rate;
• tides;
• convulsions.

Often, signs of an overdose are diagnosed in children, which is due to the incorrect determination of the dose of Uropres.

If you suspect an overdose, the doctor should reconsider the correctness of the appointment of Uropres. When the brain is swollen, the patient is hospitalized in the intensive care unit. Immediate treatment is also used in the presence of convulsions in patients of childhood.

There is no special treatment for an overdose of Uropres. If there is evidence, Furosemide is prescribed.

Interactions with other drugs

The combination of Uropres and Oxytocin can lead to an increase in antidiuretic properties and a decrease in uterine perfusion.

Strengthen the action of Uropres can be medications such as Clofibrate, Indomethacin or carbamazepine.

Weaken the action of Uropres can be preparations based on lithium salts, as well as Glibenclamide.

The combination of Uropres with Chlorpromazine, tricyclic antidepressants, selective inhibitors of reversible seizure of serotonin, non-steroidal anti-inflammatory drugs can lead to increased effectiveness of Uropres, which, in turn, can cause fluid retention in the tissues.

Any combination of Uropres with the above drugs should be monitored for changes in blood pressure, diuresis and the amount of sodium in the blood.

[2], [3]

Storage conditions

Preserve Uropres in darkened places, outside the children's access zone. The optimum temperature limits for the preservation of the drug are from + 2 ° C to + 8 ° C.

[4]

Shelf life

Uropres in the package can be stored for up to 2 years at the appropriate temperature.

After opening the bottle, the shelf life is reduced to fifty days. After the expiration date, Uropres must be discarded.