Drug Interaction:
Interacting drugs- summary
+ Vasopressin
Carbamzepine
carbamazepine which potentiates ADH potentiate the antidiuretic
effects of vasopressin, lypressin or desmopressin
Chlorpropamide
chlorpropamide which potentaites ADH potentiate the effects of
vasopressin
Indication:
Diabetes insipidus Abdominal distention /roentgenography - prevention and treatment of postoperative abdominal distention and in abdominal roentgenography
Adverse Reaction:
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.,
Contra-Indications:
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.
Dosages/ Overdosage Etc:
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.
Other Information:
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
Patient Information:
1. Side effects such as blanching, abdominal cramps, and nausea, may be
reduced by taking 1 or 2 glasses of water with the dose.
2. These side effects usually are not serious and will probably disappear within
few minutes
Ref - USP PDI Vol II 17th Edition (1997)
VASOPRESSIN- SYSTEMIC
1.Allergies-
Tell your doctor if you have ever had any unusual or allergic reaction to
Vasopressin. Also tell your healthcare care professional if you are allergic to
any other substances such as foods. preservatives or dyes.
2.Pregnancy-
Vasopressin has not been shown to cause birth defects or other problems
in humans.
3. Breast-feeding-
Vasopressin has not been reported to cause problems in nursing babies.
4.Children-
Children may be especially sensitive to the effects of vasopression. This may
increase the chance of side effects.
5.Older adults-
Although there is no specific information comparing use of vasopression
in the elderly may be more sensitive to its effects.
6. Other medicines-
Tell your doctor if you are using any other prescription or non-prescription
(Over-the counter) OTC medicine.
7. Other medical problems-
The presence of other medical problems may affect the use of vasopressin.
Make sure you tell your doctor if you have any other medical problems
especially-
Asthma or
Epilepsy or
Heart disease or
Kidney disease or
Migraine headaches - if fluid retenion ( keep more body water ) caused
by vasopression occurs too fast these conditions may be worsened
Heart or blood vessel disease - vasopression can cause chest pain or
heart attack, it can also increase blood pressure
Pharmacology/ Pharmacokinetics:
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 and lactation:
Pregnancy
Administer to pregnant women only if needed.
Lactation-
Excercise caution when giving to a nursing woman.
Manufacturer Details