Vasopressin

Provider Level

RN/Paramedic

Class

Nonapeptide hormone, Antidiuretic hormone, Vasopressor

Mechanism of Action

Directly stimulates V1 receptors in vascular smooth muscle causing intense peripheral vasoconstriction. Stimulates V2 receptors in renal collecting ducts increasing water reabsorption.

Indications

Vasodilatory shock such as septic shock, alternative or adjunct vasopressor in cardiac arrest, severe gastrointestinal hemorrhage.

Contraindications

Hypersensitivity, chronic nephritis with nitrogen retention, relative contraindication in patients with coronary artery disease due to ischemia risk.

Routes

IV, IO

Onset / Duration

Onset: 1 to 3 minutes. Duration: 10 to 20 minutes.

Adverse Effects

Myocardial ischemia, angina, arrhythmias, peripheral tissue ischemia or necrosis, mesenteric ischemia, pallor, abdominal cramps, nausea, vomiting, water intoxication, hyponatremia.

Precautions & Interactions

Use with extreme caution in patients with coronary artery disease, heart failure, or peripheral vascular disease. Monitor blood pressure closely to avoid extreme hypertension. High risk for tissue necrosis if extravasation occurs.

Special Considerations

Authorized for RN/Paramedic use. Administration via central venous access is preferred to reduce the risk of peripheral extravasation and tissue necrosis. Assess fluid status and correct hypovolemia prior to or concurrent with administration.