Vasopressin
( 8-Arginine-Vasopressin ) Pronouncation: (VAY-so-PRESS-in)Class: Posterior pituitary hormone
Trade Names:
Pitressin
- Injection 20 pressor units/mL
Pharmacology
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Feedback for Vasopressin (8-Arginine-Vasopressin)
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Promotes resorption of water through kidney. At high doses, stimulates contraction of smooth muscle causing vasoconstriction, increased peristaltic activity, and gall-bladder contractions.
Pharmacokinetics
Absorption
T max is about 2 to 8 h.
Metabolism
Majority of dose is metabolized and rapidly destroyed in the liver and kidneys.
Elimination
T ½ is about 10 to 20 min. About 5% of the dose is excreted unchanged in the urine after 4 h.
Indications and Usage
Treatment of neurogenic diabetes insipidus; prevention and treatment of postoperative abdominal distention; facilitation of abdominal roentgenography.
Unlabeled Uses
Treatment of bleeding esophageal varices.
Contraindications
Standard considerations.
Dosage and Administration
Diabetes InsipidusAdults
IM/SC 5 to 10 unit 2 or 3ߙtimes daily as needed. Intranasal injection solution may be given as an individualized dosage intranasally on cotton pledgets, by nasal spray, or dropper.
ChildrenReduce dosage proportionally.
Abdominal DistentionAdults
IM 5 unit initially; subsequent injections every 3 to 4 h as needed. May increase the dose to 10 unit if necessary.
Abdominal RoentgenographyAdults
IM/SC 2 injections of 10 unit each administered 2 h and 30 min before films are exposed.
Bleeding Esophageal VaricesAdults
IV Infuse initially at 0.2 to 0.4ߙunit/min and increase to 0.9 unit/min if necessary.
General Advice
- Give 1 to 2 glasses of water with dose to prevent skin blanching, abdominal cramps, and nausea.
- If administering via IV infusion, dilute with 0.9% normal saline or D5W to a concentration of 0.1 to 1 unit/mL. Ensure patency of venous access and use infusion control device.
Storage/Stability
Store at room temperature. Do not freeze.
Drug Interactions
Alcohol, demeclocycline, heparin, lithium, norepinephrineMay decrease the antidiuretic effect of vasopressin.
Carbamazepine, chlorpropamide, clofibrate, fludrocortisone, tricyclic antidepressants, ureaMay potentiate antidiuretic effect of vasopressin.
Ganglionic blocking agentsMay markedly increase sensitivity to vasopressin pressor effects.
Laboratory Test Interactions
None well documented.
Adverse Reactions
Cardiovascular
Angina.
GI
Abdominal cramps; nausea; vomiting; gas.
Miscellaneous
Gangrene; ischemic colitis; tissue necrosis (with extravasation); allergic reaction (cardiac arrest, tremor, vertigo, sweating).
Precautions
Pregnancy
Category C .
Lactation
Undetermined.
Hypersensitivity
Local or systemic reactions, including anaphylaxis, may occur.
Special Risk Patients
Use drug with caution in patients with epilepsy, migraine, asthma, heart failure, or any condition where a rapid rise in extracellular water may result in further compromise.
Chronic nephritis with nitrogen retention
Contraindicates use until reasonable nitrogen blood levels have been attained.
Extravasation
Severe vasoconstriction and local tissue necrosis may result if drug extravasates during IV infusion.
Vascular disease
Use extreme caution in patients with vascular disease.
Water intoxication
Water intoxication may occur. Early signs include confusion, drowsiness, listlessness, and headache.
Overdosage
Symptoms
Confusion, lethargy, drowsiness, listlessness, headache.
Patient Information
- Tell patient to take with 1 to 2ߙglasses of water to prevent skin blanching, nausea, or abdominal cramping.
- Caution patient to withhold medication and to notify health care provider of chest pain.
- Tell patient to report drowsiness, listlessness, and headache to health care provider, and to restrict water intake.
- Explain that urine output should decrease after use.
- Tell patient to monitor weight daily.
- Instruct patient to avoid alcohol intake during therapy.
- Remind patients with diabetes insipidus to carry appropriate medical identification.
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Diabetes Insipidus, Asystole, Postoperative Gas Pains, Abdominal Distension Prior to Abdominal X-ray, Esophageal Varices with Bleeding
