On-call scenario 6: Resolution

Last updated: Wednesday, June 12, 2024

What an on-call pharmacist could advise... 

As you have calculated above, you might tell the doctor to prescribe intranasal desmopressin 30-60 micrograms daily (in 1-2 divided doses) or IV/SC desmopressin 3-6 micrograms once daily. 

To be cautious, you might suggest that they go for the lower end of the dose range until the patient can be reviewed properly by the endocrine team during core working hours. The dose can always be titrated up according to response. 

Consider switching back to administering crushed oral desmopressin tablets via the NG tube when able. 

Follow up 

The next morning, ensure that you let the ward pharmacist know about the enquiry and the advice that you gave. If this was something you hadn’t come across before, you might like to have shared your learning with your on-call colleagues.