ANTIDIURETIC HORMONE (ADH)

what is mechanism of action for ADH?

• acts on collecting duct in kidneys to increase water permeability

• increase water reabsorption

• decrease urine excretion

• also acts on vascular smooth muscle and vasocontriction (increase BP)

  • vasoconstriction

    • decreases vessel diameter

    • decreases blood flow

    • increases BP

what are the other names for Antidiuretic Hormone (ADH)?

• Vasopressin

• Desmopressin

what are the indications for Antidiuretic Hormone (ADH)?

• Vasopressin

  • more selective for the vasculature

  • used for pt with hypotension

• Desmopressin:

  • synthetic form of vasopressin

  • more selective for the kidney

  • used in patients with low blood volume

• diabetes insipidus (DI): decrease in ADH

  • high urine output, dilute urine, polydipsia

• nocturnal enuresis

• hypotension and shock

what are contraindications ADH?

• hyponatremia

• HF

• renal impairment

what are adverse effects of ADH?

• water intoxication (hyponatermia)

  • headache

  • N/V

  • confusion

  • seizures

  • brain swelling, coma, death

• hypertension

what are nursing interventions for ADH?

• restrict fluid intake to prevent water intoxication

• avoid in CAD - vasoconstriction (angina, MI)

• monitor chest pain

• monitor for renal impairment

  • impaired creatinine clearance

  • strict I/Os

• monitor electrolytes

  • hyponatremia