Uses of Vasopressin
- Hyperuricemia: Can correct fluid disorders caused by temporary hyperuricemia due to decreased ADH due to neurosurgery or head injury.
- CPR: Due to the vasoconstrictive effects of this drug, it is used as a single dose as an alternative to the primary or secondary dose of epinephrine in ACLS during CPR.
- Swelling of the intestine: Used to stimulate smoky bowel movements to prevent or improve intestinal paralysis, swelling of the intestine after surgery, and swelling caused by pneumonia or blood poisoning.
- Intestinal radiography
- Vasodilatory shock: Used if other vasoconstrictors are not effective in septic shock syndrome.
Mechanism of action of Vasopressin
By increasing cellular permeability in the urinary tract, this drug increases water reabsorption, followed by a decrease in urine volume and osmolarity. With amounts higher than the physiological amount of vasopressin, it causes narrowing of blood vessels and contraction of gastrointestinal smooth muscle.
Pharmacokinetics of Vasopressin
The metabolism of the drug is hepatic and its half-life is 10-20 minutes. The duration of action of the drug is 2-8 hours and 5-15% of the drug is secreted unchanged by the kidneys after intravenous administration.
Contraindications to the use of Vasopressin
The drug should not be used in vascular diseases (especially coronary artery disease) and high blood pressure, as well as in chronic nephritis with nitrogen retention.
Hypersensitivity to the drug
Side effects of Vasopressin
- Cardiovascular: atrial fibrillation, bradycardia, ischemic heart disease, ischemia of the limbs (distal), low cardiac output, right heart failure, shock (bleeding)
- Skin: Skin ulcers
- Endocrinology and metabolism: Decreased blood sodium
- Gastrointestinal: Mesenteric artery ischemia
- Hematology and oncology: decreased platelet count, bleeding (uncontrollable)
- Liver: Increased serum bilirubin
- Renal: Renal insufficiency
- Headache, dizziness, tremor
- Vascular contraction in case of arterial injection: bradycardia, palpitations, pulmonary edema
- Mild abdominal cramps, nausea, vomiting, diarrhea, hypertension
- Uterine cramps, anuria
- Water poisoning, hypersensitivity reaction
Drug Interactions
– Intensifying the antihypertensive effects
– Exacerbation of hyponatremia
Warnings
With high doses there is a possibility of oxytocic effects. If taken during pregnancy, because vasopressin is inactivated by the placenta, larger doses may be needed.
There is a risk of water poisoning and hyponatremia in children and the elderly.
Use with caution in cases such as heart disease, asthma, epilepsy, migraines and other conditions that may be exacerbated by water retention, kidney damage, and fluid retention.
Important points
Vasopressin is a natural hormone in the body that is secreted by the posterior pituitary gland. This hormone is also known as antidiuretic hormone. The hormone vasopressin affects the kidneys and blood vessels.
Vasopressin prevents water from leaving the body by reducing the volume of urine, and helps the kidneys reabsorb water from the fallopian tubes and retain water in the body.
Vasopressin also increases blood pressure by narrowing the blood vessels in the neck.
Vasopressin has two types of receptors in the body. Vasopressin receptors are type 1 in the body’s arteries, and after the release of vasopressin and the effect on these receptors, the arteries constrict and blood pressure rises. Vasopressin type 2 receptors are present in the urethra and after the effect of vasopressin on them, it increases the reabsorption of water by the kidneys and reduces the volume of urine.
In case of water poisoning by vasopressin, limit water intake and do not use the drug temporarily to cause urinary incontinence. In severe cases, it is necessary to use mannitol, concentrated dextrose or urea alone or in combination with ferrosamide (diuretic) under the supervision of a physician to treat water poisoning.
Attention
If you inject the drug subcutaneously or subcutaneously, change the injection site regularly.
You need to control the amount of water consumed and excreted.
Drink one or two glasses of water with the injection. This reduces side effects such as nausea or abdominal pain. These symptoms are often not severe and go away quickly.
Use the medicine exactly as your doctor advised. Avoid increasing the dose of the drug. If you forget to take a dose, take it immediately after remembering, unless there is no opportunity until the next dose.
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