Magnetic resonance imaging of the brain is essential in the diagnosis of central diabetes insipidus. Normally, the neurohypophysis is a region of bright glow in T1-weighted images. A bright spot of the neurohypophysis is absent or weakly traced in the central form of diabetes insipidus, mainly due to reduced synthesis of vasopressin in the central form of the disease. During primary polydipsia, the bright spot of the neurohypophysis retains, probably due to the fact that vasopressin accumulates in the neurohypophysis during the period of prolonged fluid intake in the body. In addition, MRI detects tumors, malformations of the hypothalamic-pituitary region, in which there can be diabetes insipidus.
Treatment
Until recently as a replacement therapy central (neurogenic), diabetes insipidus applicable preparation Adiuretin (Desmopressin, Ferring) for Intral Zal Nogo application. Currently, the main treatment drug is the tablet form of desmopressin – Minirin (Desmopressin, Ferring).
In the Endocrinological Scientific Center of the Russian Academy of Medical Sciences and the Moscow Medical Academy. THEM. Sechenov conducted an open study on the development of a regimen for using a tablet form of desmopressin – the drug MINIRIN (“MINIRIN”, Ferring), for the treatment of centrally unsantious diabetes.
Characteristics of the drug
Minirin (desmopressin, 1-deamino-8-D-arginine-vasopressin) is a synthetic analogue of the natural antidiuretic hormone of the posterior lobe of the pituitary gland arginine-vasopressin, which regulates water reabsorption, acting directly on the kidneys through the V2 receptors. Structural modifications of Minirin (the absence of an amino group at position 1 and the replacement of “L” -on “D” arginine at position 8) increase the stability of the Mininin drug molecule to enzymatic cleavage, enhance antidiuretic activity and eliminate the vasopressor effect (does not affect smooth muscle). Thus, Minirin has a more powerful prolonged antidiuretic effect.
After taking Minirin (tab.), Desmopressin begins to be detected in the blood plasma in 15-30 minutes. The maximum concentration is reached no later than 2 hours after taking the drug. After oral administration of desmopressin, its absorption occurs mainly in the duodenum and proximal small intestine. With the rapid passage of the drug through these parts of the intestine, its absorption may be less effective (when taking the drug Minirin with food).
Clinical studies have shown the effectiveness of Minirin tablets in patients with central diabetes insipidus in various clinics in the world, where the drug has been used since the 80s.
Minirin is available in tablets of 0.1 and 0.2 mg. 30 pieces per pack.