On-call scenario 6: Introduction
"Hello. One of my patients usually takes desmopressin tablets. They are struggling to swallow, and so the endocrine team has suggested switching to IV/SC or intranasal desmopressin instead. Please could you help us with dosing equivalents?"
You ask the caller a few more questions, and get the following information…
Caller: Dr Belter, FY1, bleep 1146.
Patient: Nicole Singh, hospital no. 0764432, age 78 years.
Medicines: Desmopressin tablets 200 micrograms TDS. Also prescribed rivastigmine and paracetamol.
Clinical problem: The patient has cranial diabetes insipidus and usually takes oral desmopressin. They can’t swallow tablets safely currently as they have dementia and are agitated. The patient initially had an NG tube inserted but have pulled this out and the medical team cannot get another one inserted out-of-hours.
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