In a few studies, desmopressin (DDAVP) has been shown to dramatically reduce the pain of acute renal colic. It has direct relaxing effect on the renal pelvic and ureteral musculature and reduces intraureteral pressure. A central analgesic effect through the release of hypothalamic beta-endorphins has been proposed but remains unproven. In human studies, approximately 50% of 126 patients tested had complete relief of their acute renal colic pain within 30 minutes after the administration of intranasal desmopressin without any analgesic medication. Whether this therapy significantly affects eventual stone passage is unknown. Desmopressin currently appears to be a promising alternative or adjunct to analgesic medications in patients with acute renal colic, especially in patients in whom narcotics cannot be used or in whom the pain is unusually resistant to standard medical treatment.

As for tamsulosin, α1-adrenergic receptors are demonstrated in the distal ureter and ureterovesical junction, where antagonists such as tamsulosin are able to inhibit basal muscle tone, reduce peristaltic frequency, and weaken ureteral contractions in the distal and intramural ureter. Spontaneous stone passage rates have been shown to increase by approximately 30% in patients with ureterovesical and distal ureteral stones treated with tamsulosin compared with controls. It’s proposed that this may be substituted for nifedipine, for its muscle relaxing effect.

ENTER KEYWORD(S)

To search a phrase, use quotation marks (e.g. "back pain")