Vasopressin

Vasopressin

[1 vial $56.76]

ADMINISTRATION ROUTES:

  • IV

ALTERNATIVE NAMES:

  • Pitressin

ICU INDICATIONS:

  1. refractory septic shock
  2. severe post-cardiopulmonary bypass vasoplegia

PRESENTATION AND ADMINISTRATION:

  • IV: 20 units in 1ml glass vials
    Administer by IV infusion. Make 20 units of vasopressin up to a total of 20ml of compatible IV fluid.
    Compatible with the following IV fluids: 5% dextrose normal saline
    Administer via a central line. Store at room temperature Section 29 medicine.

DOSAGE:

  • IV: 0-2 units/hr

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

  • IV: Vasopressin has been shown to increase the risk of death in children with septic shock; it should not be used except on the advice of a Paediatric Intensivist (i.e. Starship Consultant)

CLINICAL PHARMACOLOGY:

  • Vasopressin is a potent vasopressor which is an analogue of the posterior pituitary hormone ADH. Vasopressin binds to different receptors than the catecholamine pressors. Vasoconstrictor effects are through the V1 vascular receptors

CONTRAINDICATIONS:

  1. hypersensitivity to vasopressin

WARNINGS

  • See PRECAUTIONS

PRECAUTIONS

  • General: Vasopressin is a potent vasoconstrictor. Due to its effect on afterload, vasopressin may increase myocardial oxygen demand and lead to myocardial ischaemia.
  • Laboratory Tests: No tests are required in addition to routine ICU tests.
  • Drug/Laboratory Test Interactions: None known

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Vasopressin acts via different receptors than other vasoconstrictor agents; it may lead to significant reductions in noradrenaline requirements.

ADVERSE REACTIONS

  • Cardiovascular: Arrhythmias including asystole, hypertension, reduced cardiac output, chest pain, MI, venous thrombosis C
  • entral nervous system: Pounding in head, fever, vertigo.
  • Dermatologic: Ischemic skin lesions, circumoral pallor, urticaria
  • Gastrointestinal: Abdominal cramps, flatulence, mesenteric ischemia, nausea, vomiting
  • Genitourinary: Uterine contraction
  • Neuromuscular & skeletal: Tremor
  • Respiratory: Bronchial constriction
  • Metabolic: Hyponatraemia & water retention

Critical Care Drug Manual

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