VASOPRESSIN

Mechanism of Action

It reabsorbs water by concentrating urine in the collecting ducts of the nephrons and constricting the smooth muscles in capillaries and tiny arterioles.

Indication

(Central) Neurogenic Diabetes Insipidus

• Test for diabetic insipidus with dehydration
• Hemorrhage caused by an esophageal varice or a stomach ulcer.
• In cases of acute septic shock, as an adjunct to norepinephrine.
• Asystole, ventricular fibrillation, and pulseless ventricular fibrillation (in cardiac arrest, an alternative to the first or second dosage of epinephrine).

Dose

• Adult
  • Post-Cardiotomy Shock
    • Maximum 0.1U/min; initially 0.03U/min. Initially 0.010/minute (maximum 0.07U/min) in septic shock If goal BP is not reached, titrate up by 0.005U/minute at intervals of 10-15 minutes. Taper by 0.005U/min per hour as tolerated when target BP has been maintained for 8 hours without the usage of catecholamines to keep target BP at the desired level.
  • Diabetes Insipidus
    • 5-10u IM/SC 2-4 times per day, as necessary.

Contraindication

• Pregnancy, lactation, nephrogenic diabetes insipidus, nephritis with nitrogen retention, ischemic heart disease, and coronary artery disease

Side Effect

• Gangrene at the injection site with intraarterial infusion, rash, urticaria, anaphylaxis, tremor, sweating, bronchoconstriction, facial pallor, and circumoral edema vomiting, heartburn, cramping in the abdomen, high blood pressure, mild bradycardia arrhythmias, premature atrial contraction, and heart block. Postnasal drip, mucosal ulceration, uterine pains, peripheral vascular collapse, and cardiac arrhythmia.

Nursing Consideration

• Send IM Deeply inject into a sizable muscle.
• Take care not to inject ID when using SC injection.
• Keep an eye on young children and newborns. Compared to adults, they are more vulnerable to volume disruptions (such a fast reversal of polyuria).
• Create baseline data for your blood pressure, weight, and ratios of 1 and 0. Track your weight and blood pressure during treatment. If a pattern suddenly changes, consult a doctor.
• To avoid overhydrating, keep an eye on your fluid consumption.
• Patients with epilepsy, migraine, asthma, angina, and coronary artery disease should use with caution.
• Vasopressin should be injected intravenously, and no more than 0.75ml should be given subcutaneously or intramuscularly.
• Throughout therapy, do periodic checks on the patient's orientation and attention. Although it develops slowly, water intoxication can cause convulsions and a fatal coma. These symptoms include drowsiness, confusion, and headaches.
• While the patient is hospitalized, keep track of his or her urine output, specific gravity, and serum osmolality.
• If the urine's specific gravity is less than 1.015, inform your doctor.