Name: VASOPRESSIN (PressynR)
Classification: antidiuretic hormone
  • stimulates vascular vasopressin V1 receptors to cause vasoconstriction; tends to not cause hypertension in normotensive patients
  • stimulates vasopressin V2 receptors in the renal tubules to cause fluid retention and prevent fluid loss
  • no alpha or beta adrenergic receptor activity thus may be effective in vasodilatory shock unresponsive to catecholamines or in the presence of acidosis/hypoxia, and will enhance myocardial oxygen delivery without an increase in consumption
Dose:
  • treatment of septic shock:  0.09 to 1.8 u/hr. Do not titrate, run at fixed dose.
  • organ donor management :  0.09 to 1.8 u/hr. Do not titrate, run at fixed dose.
  • refractory pulseless cardiac arrest:  40 units IV X 1
Administration: IV Infusion
50 units in 50 ml D5W or NS
  • hypovolemia, hypoxemia and acidosis should be corrected concurrently with initiation of therapy
  • should be weaned off 
Adverse Effects:

 

  • GI ischemia
  • coronary ischemia
  • fluid retention
  • sweating
  • tremor
  • abdominal cramping, nausea, vomiting, eructation, diarrhea
  • bradycardia
  • arrhythmias
  • decreased cardiac output
Drug Interactions:
  • vasopressin + ganglionic blocking agents = increased vasopressin pressor effect
  • vasopressin + lithium = decreased antidiuretic activity
  • vasopressin + carbamazepine = increased antidiuretic activity
Monitoring Therapy:
  • BP 
  • HR, ECG
  • urine output, BUN, creatinine 
  • cardiac index 
  • SVRI 
  • arterial lactate 
  • PWP 
  • changes in skin colour or temperature 
  • chest pain, diarrhea, abdominal pain  
  • CCTC Protocol:
    • May be administered by IV infusion by an approved nurse in CCTC.
    • Must be administered via a central line.
    • Continuous infusion must be administered via an infusion pump. 
    • Should not be infused via the proximal injectate port (blue) of the Swan Ganz catheter. 
    • Patient requires placement of an arterial line to monitor BP. 


    Lynne Kelly, Pharmacist, CCTC
    Brenda Morgan, Clinical Nurse Specialist, CCTC
    Last Update: January 19, 2017, July 25, 2017

    LHSCHealth Professionals

    Last Updated July 25, 2017 | © 2007, LHSC, London Ontario Canada