Fluids are withheld and the urine volume and concentration are monitored. A dose of this medication stops the abnormal diuresis that occurs in DI and results in cessation of the symptoms. An MRI or CT scan of the hypothalamic-pituitary region is done in children when the cause of DI is not known. Affected children usually have an intact thirst mechanism and need free access to water. Initial dose adjustment and education occur during the hospital stay.
Most children require one or two doses daily, at bedtime and in the morning.
The dose is response-based and ranges from 0.05 to 0.2 ml per day. In infants and younger children, the volume required may be so small that it cannot be properly measured in the insufflation tubing. An accurate measuring device can be constructed by cutting off the needle of a butterfly infusion set and attaching the thin tubing to a tuberculin syringe. Administration of the dose while the infant is asleep is advised to avoid the conflict that results when the nares are entered. Children may swallow the dose instead of inhaling it when the volume is too great or their nasal surface area is too small.