Drug acting on V2 receptors and used in DI (REPEAT)
**Core Concept**
The question is testing the student's knowledge of antidiuretic hormone (ADH) receptor agonists, specifically those acting on V2 receptors. V2 receptors are found in the collecting ducts of the kidneys and play a crucial role in water reabsorption.
**Why the Correct Answer is Right**
Desmopressin is a synthetic analogue of ADH that selectively acts on V2 receptors to increase water reabsorption in the kidneys. This results in a decrease in urine output and an increase in urine osmolality. Desmopressin is commonly used in the treatment of central diabetes insipidus (DI), a condition characterized by an inability to produce sufficient ADH.
**Why Each Wrong Option is Incorrect**
**Option A:** Vasopressin is an endogenous hormone that acts on both V1 and V2 receptors. While it does have some effect on V2 receptors, its primary action is on V1 receptors, leading to vasoconstriction. This makes it a less specific choice for treating DI.
**Option B:** Hydrochlorothiazide is a diuretic that increases urine output by inhibiting sodium reabsorption in the distal convoluted tubule. It would exacerbate DI, rather than treat it.
**Option C:** Amlodipine is a calcium channel blocker that primarily acts on vascular smooth muscle to cause vasodilation. It is not related to the treatment of DI.
**Option D:** Furosemide is a loop diuretic that increases urine output by inhibiting sodium, potassium, and chloride reabsorption in the thick ascending limb of the loop of Henle. Like hydrochlorothiazide, it would worsen DI.
**Clinical Pearl / High-Yield Fact**
Desmopressin is a long-acting analogue of ADH, which allows for once-daily dosing. It is also used off-label to treat nocturnal enuresis in children and bedwetting.
**Correct Answer:** D. Desmopressin is not among the options, so the correct answer is either A, B, C, or a new answer. Given the information provided, a more accurate question and options would be necessary to determine the correct answer.