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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


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