Diabetes insipidus Abdominal distention /roentgenography - prevention and treatment of postoperative abdominal distention and in abdominal roentgenography 

Local or systemic allergic reactions may occur in hypersenstive individuals. Tremor, "pounding in the head" abdominal cramps, passage of gas, nausea, vomiting, urticaria, sweating, vertigo, bronchial constriction, gagrene,

Anaphylaxis (cardiac arrest and or shock) has been observed shortly after injection of vasopression.,

Contraindications in patients who are hypersensitive to the drug.

Special precautions:

To be used with caution in patients with vascular disease, especially disease of coronary arteries Early signs of drowsiness, listlessness, and headache should be recognized to prevent terminal coma and convulsions as vasopressin may produce water intoxication. Chronic nephritis with nitrogen contraindicates the use of vasopressin until reasonable nitrogen blood levels have been attained.

Subcutaneous or intramuscular dosage should not exceed 0.75ml Use cautiously in the presence of epilepsy, migraine, asthma, toxemia of pregnancy, nephritis, with arterial hypertension, goitre and cardiac complications.

Electrocardiogram(ECG) and fliud electrolyte status determination are recommended at periodic intervals during therapy Caution to be excercised when vasopressin is administered to nursing woman.

Monitoring- electrocardiogram and fluid electrloyte status determinations are recommended at intervals during therapy

Special risk patients- use vasopressin cautriously in the presence of epilepsy, migraine, asthma, heart failure, or any state in which a rapid increase in extracellular water may result in further compromise.

Warnings-

Vascular disease- use with extreme caution in patients with vascular disease(especially coronary artery disease) since even small doses may precipitate anginal pain. With larger dooses consider the possibility of MI.

Water intoxification- vasopressin may produce water intoxification . Early signs of drowsiness, listlessness,and headache precede terminal coma and convulsions.

Vasoconstrictions/necrosis- severe vasoconstriction and local tissue necrosis may result with if vasopressin extravates during IV infusion. Gnagrene of the extremities, tongue,necrosis, and ischemc colitis may occur during treatment of esophageal varices.

Chronic nephritis- with retention contraindicates use until reasonable nitrogen blood levels have been attained.

Hypersenitivity- local or allergic reactons may occur in hypersentive individuals.anaphlaxis(cardiacarrest or shock) has been observed shortly after injection.

Pregnancy- administer to pregnant women only if needed.

Lactation- excercise caution when giving to a nursing woman.

Diabetes insipidus

Abdominal distention /roentgenography - prevention and treatment of postoperative abdominal distention and in abdominal roentgenography

Dosage-

May be given IM or SC Adults - 5 to 10 units usually elicit full physiologic response . Give IM at 3 or 4 hour intervals as needed. Reduce dosage propotionately for children.

Diabetes- parentral - 5 to 10 units 2 to 3 times daily as needed Abdominal radiography- Two IM or SC injection of 0.5ml each (10 units) are suggested

Missed dose-

 1. If you miss a dose of this medicine, take it as soon as possible.

2. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

3. Do not double doses.

Exacerbation of Angina- ( 1118 )

Angina pectoris is a clinical syndrome resulting from transcient myocardial ischemia. The patient commonly declines to apply the word - pain- to his chest symptoms, may have difficulty describing the sensation and will usually select words such as heaviness, pressure smothering , toghtness, choking, or squeezing. The typical discomfort is substernal in location, but other sites are also commonly involved.

Drugs causing adverse raections- ( 386)

1. Vasopresin

2. Oxytocin

3. Ergotamine

4. Methysergide

5. Propranol withdrawal

6. Excessive thyroxin

7. Alpha blockers

8. Hydralazine

Pharmacology:

Vasopressin is a hormone endogenously released from the pituitary glands in humans. Vsasopressin is primarily responsible for effects as antidiuretic hormone in maintaining water balance in the kidney. The antiodiuretic action of vasopressin is ascribed to increasing reabsorption of water by the renal tubules. Vasopressin can cause the contraction of smooth muscles of the gastrointestinal tract and of all parts of the vascular bed, especially the capillaries, small arterioles and venules, with less effect on the smooth musculature of large veins.

Pharmacokinetics:

Subcutaneous or intramuscular administration of vasopressin is metabolised and rapidly destroyed in the liver and kidneys. Vasopressin has a plasma half-life of about 10 to 20 minutes. approximately 5% of a subcutaneous dose of vasopressin is excreted in urine unchanged after 4 hours.

Pregnancy

Administer to pregnant women only if needed.

Lactation-

Excercise caution when giving to a nursing woman.