Noctural enuresis

What’s the drug treatment for noctural enuresis for children over 5

1.) give desmopressin, and assess treatment after 4 weeks, continue for 3 months if responding it

2.) add an anti-muscarnic with desmopressin

3.) can use imipramine if previous treatments haven’t worked

What’s the interactions of desmopressin

SSRIs

Diuretics

Carbamazepine

lead to hyponatraemia

What are the contraindications of desmopressin

hx of hyponatraemia

diuretic use

65+

What are the counselling points of desmopressin

drink to only satisfy thirst in 1-2 hours before sleeping

avoid drinking 8 hours after dose 

What are the side effects of desmopressin

headache, nausea and convulsions due to hyponatraemia

What’s the treatment for noctural enuresis for children under 5

1.) enuresis alarm

2.) if alarm treatment isn’t succesful add in/replace with desmopressin

What lifestyle advice can you give regarding noctural enuresis

fluid intake

diet

toileting patterns

use of reward systems