vay-soe-PRESS-in
Therapeutic Classification: hormones
Pharmacologic Classification: antidiuretic hormones, vasopressors
High Alert
Absorption: IM absorption may be unpredictable. IV administration results in complete bioavailability.
Distribution: Well distributed to tissues.
Half-Life: <10 min.
Contraindicated in:
Use Cautiously in:
CV: angina, chest pain, MI
Derm: ↑sweating, paleness, perioral blanching
Endo: diabetes insipidus
F and E: water intoxication (higher doses)
GI: abdominal cramps, belching, diarrhea, flatulence, heartburn, nausea, vomiting
Neuro: "pounding" sensation in head, dizziness, trembling
Misc: allergic reactions, fever
Drug-drug:
Diabetes Insipidus
Vasodilatory Shock
GI Hemorrhage
Lab Test Considerations:
Toxicity and Overdose:
IV Administration:
Vasopressin is a vesicant. Central line administration is preferred. If extravasation occurs, immediately stop infusion. Leave needle/cannula in place temporarily but do not flush the line. Gently aspirate extravasated solution; then remove needle/cannula. Elevate patient's extremity and apply dry warm compresses. Initiate nitroglycerin topical ointment antidote for refractory cases in addition to supportive management. For nitroglycerin, apply 1-inch strip of 2% topical ointment to site of ischemia to cover affected area; may repeat every 8 hr as necessary. Phentolamine or terbutaline may be used as alternatives to topical nitroglycerin. For phentolamine, dilute 5–10 mg in 10 mL of 0.9% NaCl and administer SUBQ into extravasation site as soon as possible after extravasation; if IV catheter remains in place, administer initial dose IV through the infiltrated catheter. May repeat in 60 min if patient remains symptomatic. For terbutaline, for large areas of extravasation, dilute 1 mg in 10 mL of 0.9% NaCl and administer SUBQ into extravasation site; may repeat in 15 min if necessary; for small areas of extravasation, dilute 1 mg in 1 mL of 0.9% NaCl and administer 0.5 mg (0.5 mL) SUBQ into extravasation site; may repeat in 15 min if necessary.