Which factor must be monitored when using DDAVP for primary enuresis?

• A. Adequate fluid intake
• B. Increased drowsiness
• C. Bladder outflow obstruction
• D. Symptoms of glaucoma

Answer: (A)

Desmopressin lowers nighttime urine production by acting as a vasopressin analog, increasing water reabsorption in the kidneys’ collecting ducts. Because it causes the body to hold onto water, there’s a real risk of water overload and dilutional hyponatremia if fluid intake is not controlled, especially after taking the dose in the evening. The key safety step is monitoring and limiting fluid intake to prevent hyponatremia (for example, restricting fluids after bedtime dosing). This makes fluid intake management the most important factor to watch with DDAVP for primary enuresis. Other issues like increased drowsiness, bladder outflow obstruction, or glaucoma symptoms aren’t the primary monitoring focus for this medication.