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Maximal dose response occurred at 0. The increase is rapid and evident within 30 minutes, reaching a maximum at a point ranging from 90 minutes to two hours. The factor VIII related antigen and ristocetin cofactor activity were also increased to a smaller degree, but still are dose-dependent. Terminal half-life significantly increased from 3 hours in normal healthy patients to 9 hours in patients with severe renal impairment.
Other patients may respond in a variable fashion depending on the type of molecular defect they have. However, this means of delivery can be compromised by a variety of factors that can make nasal insufflation ineffective or inappropriate. These include poor intranasal absorption, nasal congestion and blockage, nasal discharge, atrophy of nasal mucosa, and severe atrophic rhinitis.
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Intranasal delivery may be inappropriate where there is an impaired level of consciousness. In addition, cranial surgical procedures, such as transsphenoidal hypophysectomy, create situations where an alternative route of administration is needed as in cases of nasal packing or recovery from surgery. Unless properly diagnosed and treated hyponatremia can be fatal. Careful medical supervision is required.
Particular attention should be paid to the possibility of the rare occurrence of an extreme decrease in plasma osmolality that may result in seizures which could lead to coma.
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No causality has been determined, however, the drug should be used with caution in these patients. Severe allergic reactions have been reported rarely. The skin bleeding time may be helpful in following these patients. In some cases, plasma osmolality may be required. The concomitant administration of drugs that may increase the risk of water intoxication with hyponatremia, e. Teratology studies in rats and rabbits at doses from 0. There are, however, no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
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