Desmopressin is commonly used in the treatment of which of the following?

Appeared in: DSSSB October 2024

Explanation

Desmopressin is a synthetic analog of the hormone vasopressin, used to manage certain bleeding disorders.
It functions by stimulating the release of stored Factor VIII and von Willebrand factor (vWF) from the inner lining of blood vessels (endothelium).
This action temporarily increases the levels of these clotting factors in the blood, aiding in clot formation.
It is effective for treating mild to moderate Haemophilia A (Factor VIII deficiency) and Type 1 von Willebrand disease, but not severe haemophilia or Haemophilia B.

Option A: Aplastic anaemia is a bone marrow failure disorder where the body stops producing enough new blood cells. Its treatment does not involve desmopressin.
Option C: Polycythemia is a type of blood cancer that causes the bone marrow to make too many red blood cells. Desmopressin is not used in its management.
Option D: Thalassaemia is a genetic blood disorder characterized by less hemoglobin and fewer red blood cells than normal. Desmopressin has no role in its treatment.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological treatment of bleeding disorders helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing responsibility when administering desmopressin is to monitor for water intoxication and hyponatremia (low sodium), as the drug causes fluid retention. Signs include headache, nausea, and confusion.
Nurses must educate patients to restrict fluid intake for a period before and after receiving desmopressin to minimize the risk of hyponatremia.
What if? If the patient had severe Haemophilia A instead of mild, desmopressin would be ineffective. This is because in severe disease, there are insufficient stores of Factor VIII for desmopressin to release. The patient would require infusions of recombinant or plasma-derived Factor VIII concentrate instead.

How to Approach the Question

First, identify the drug mentioned in the question stem: Desmopressin.
Recall or look up the primary indications and mechanism of action of this drug. Desmopressin is related to ADH (antidiuretic hormone) but also has effects on clotting factors.
Evaluate each option to see which condition is treated by Desmopressin's effect on clotting.
Haemophilia is a clotting factor deficiency. Desmopressin boosts Factor VIII, making it a plausible treatment.
Rule out the other options by considering their pathophysiology. Aplastic anaemia, polycythemia, and thalassaemia are disorders of blood cell production or hemoglobin, not clotting factors that desmopressin affects.

Concept Tested & Keywords

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Practise the full DSSSB October 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.