Vasopressin
Trade Names: Pitressin, Pressyn
Class: Naturally occurring antidiuretic hormone
Pharmacology:
Onset: Immediate
Duration: variable
Directly stimulates smooth muscle of V1 receptors. When given in extremely high doses, it acts as a noradrenergic peripheral vasoconstrictor. Vasopressin may be used as an alternative pressor to epinephrine in adult shock-refractory VF; in asystole and PEA; and for hemodynamic support in septic shock
Indications: As an alternative pressor to epinephrine in adult cardiac arrest, Vasodilatory shock
Contraindications: Responsive patients with coronary artery disease
Cautions: None significant
Packaging: 20 units/mL
Dosage:
Adult:
- VF/ cardiac arrest: 40 units IV/IO push; may replace 1st or 2nd dose of epinephrine
- Vasodilatory shock: continuous infusion of 0.02-0.04 units/min
Pediatric:
- Cardiac Arrest: 0.4-1 unit/kg IV/IO bolus (Max 40 units)
- Hypotension: Continuos infusion 0.0002-0.002 unit/kg/min
Side Effects:
Ischemic chest pain
dAbdominal distress
Sweating
Nausea and vomiting
Tremors
Bronchial constriction
Uterine contractions
Special Considerations:
Pregnancy safety – Category C
Vasopressin may increase peripheral vascular resistance and provoke cardiac ischemia and angina
Not recommended for responsive patients with coronary artery disease