Document Detail

Oral ddAVP for nighttime urinary incontinence in characterized nursing home residents: a pilot study.
MedLine Citation:
PMID:  16413428     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To (1) identify abnormalities in arginine vasopressin (AVP, a water-conserving hormone) secretion and release in nursing home (NH) residents with nighttime urinary incontinence (UI); and (2) perform a pilot test of desmopressin acetate (ddAVP, a synthetic analog of the naturally occurring hormone) replacement in these residents. DESIGN: Diagnostic evaluation and open-label treatment trial. SETTING: Two community nursing homes in a metropolitan area. PARTICIPANTS: Male and female NH residents 65 years of age and older with nighttime UI. INTERVENTION: Characterizations of AVP status followed by a 7-day open-label trial of oral ddAVP (either 0.1 mg or 0.2 mg). MEASUREMENTS: Water deprivation test results, AVP levels, voided volumes, number of voids, incontinent episodes, number of nighttime checks found wet (out of 6 total checks per night). RESULTS: All participants had measurable AVP levels of 2.0 pg/mL or higher. Six of 10 individuals had an abnormal water deprivation test. Two of 4 participants on 0.2 mg of ddAVP and 2 of 6 participants on 0.1 mg had a 200 mL or more mean reduction in nighttime urine volume. Both ddAVP dosages yielded a mean reduction of 0.7 fewer nighttime wet checks found wet. One participant in each group developed hyponatremia (1 of 6 on 0.1 mg and 1 of 4 on 0.2 mg). Hyponatremia resolved with discontinuation of the drug. CONCLUSION: Both 0.1 mg and 0.2 mg of ddAVP given to carefully screened NH residents for 7 days produced a modest average reduction in nighttime urine volume and number of nighttime incontinent episodes that is likely of little clinical importance. The role of ddAVP in this population requires further research.
Theodore M Johnson; Myron Miller; Terence Tang; Dennis J Pillion; Joseph G Ouslander
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2005-06-06
Journal Detail:
Title:  Journal of the American Medical Directors Association     Volume:  7     ISSN:  1525-8610     ISO Abbreviation:  J Am Med Dir Assoc     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-17     Completed Date:  2006-06-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  100893243     Medline TA:  J Am Med Dir Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  6-11     Citation Subset:  IM    
The Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Atlanta, GA 30033, USA.
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MeSH Terms
Administration, Oral
Age Factors
Aged, 80 and over
Antidiuretic Agents / adverse effects,  therapeutic use*
Arginine Vasopressin / blood*
Deamino Arginine Vasopressin / adverse effects,  therapeutic use*
Diapers, Adult
Enuresis / diagnosis,  drug therapy*,  metabolism*
Geriatric Assessment
Hyponatremia / blood,  chemically induced
Nursing Homes
Pilot Projects
Sodium / blood
Time Factors
Treatment Outcome
Water Deprivation
Grant Support
5-R37-AG08678/AG/NIA NIH HHS
Reg. No./Substance:
0/Antidiuretic Agents; 113-79-1/Arginine Vasopressin; 16679-58-6/Deamino Arginine Vasopressin; 7440-23-5/Sodium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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