It may also have a direct effect on the blood vessel wall, by causing increased platelet spreading and adhesion at injury sites. The most common side effects of desmopressin nasal spray are facial flushing and warmth, dizziness, headache, palpitations, nausea, fatigue, red eyes, decreased diuresis, nasal congestion, rhinitis and tachycardia. The new monograph reflects the deletion of the Glucagon for Injection two-vial format and the Glucagon Emergency Kit, and the addition of the new format Glucagon Kit for Treatment of Hypoglycemic Reactions. A warning has been added that the product is intended for intravenous use only, and can be fatal if injected intrathecally. The median time to occurrence was three to four weeks, but has ranged from the first day to more than 12 weeks of therapy.
Treatment consists of discontinuation of ticlopidine, and plasmapheresis.
Platelet transfusion is not recommended and could be harmful. Among the numerous changes, the drug is now contraindicated in patients with hepatic impairment or active liver disease. It also should not be used in patients receiving pentoxifylline, since the combination results in an increased bleeding tendency. Lu-Ann Murdoch is consulting clinical editor of Pharmacy Practice, consulting pharmacist for Patient Care, and a member of the editorial staff of The Pharmacist's Letter.