Vasopressin
[1 vial $56.76]
ADMINISTRATION ROUTES:
- IV
ALTERNATIVE NAMES:
- Pitressin
ICU INDICATIONS:
- refractory septic shock
- 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:
- 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
About Mike Cadogan
