バソプレシン
Vasopressin
Arginine vasopressin / Antidiuretic hormone (ADH)
別名: Pitressin · Neo-Lidocaton · Pressyn · ADH · Antidiuretic hormone · 8-arginine vasopressin · beta-hypophamine
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Diagnostic agent (Exogenous vasopressin test after water deprivation test) | 2.5 mU/kg IV over one hour | IV | Once | 1 hour | 🌎 NA |
| Adjunctive treatment of vasodilatory shock (unresponsive to fluids/catecholamines) | 0.01-0.04 Units/minute IV | IV | CRI | — | 🌎 NA |
| CPCR (pulseless electrical activity or ventricular asystole) | 0.2-0.8 Units/kg, IV once | IV | Once | — | 🌎 NA |
- Diagnostic agent (Exogenous vasopressin test after water deprivation test): Give aqueous vasopressin in D5W. Empty bladder and collect urine at 30, 60, and 90 minutes.
- Adjunctive treatment of vasodilatory shock (unresponsive to fluids/catecholamines): Dose is not dependent upon patient weight. DO NOT exceed 0.04 Units/minute (risk of myocardial ischemia). DO NOT use in cardiogenic shock.
- CPCR (pulseless electrical activity or ventricular asystole): May be beneficial for myocardial and cerebral blood flow.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Diagnostic agent (after water deprivation test) | 0.5 U/kg IM | IM | Once | — | 🌎 NA |
| Adjunctive treatment of vasodilatory shock (unresponsive to fluids/catecholamines) | 0.01-0.04 Units/minute IV | IV | CRI | — | 🌎 NA |
| CPCR (pulseless electrical activity or ventricular asystole) | 0.2-0.8 Units/kg, IV once | IV | Once | — | 🌎 NA |
- Diagnostic agent (after water deprivation test): Empty bladder and determine specific gravity at 30, 60, and 120 minutes after administration.
- CPCR (pulseless electrical activity or ventricular asystole): May be beneficial for myocardial and cerebral blood flow.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
バソプレシン（抗利尿ホルモン、ADHとも呼ばれる）は、視床下部で合成され下垂体後葉に貯蔵される内在性ペプチドホルモンです。獣医療においては以下の重要な役割を果たします：
- 診断薬：主に水制限試験において、中枢性尿崩症と腎性尿崩症を鑑別するために使用されます。
- 救急・集中治療：血管拡張性ショックの補助治療や、心肺脳蘇生（CPCR）時の使用が増加しています。
臨床のポイント：重度のショックや心停止（心室静止/無脈性電気活動）の状態において、バソプレシンはエピネフリンよりも明確な利点を提供します。アシドーシス環境下でも強力な血管収縮を引き起こし、冠状動脈および腎血管を保護（心筋灌流を改善）し、カテコールアミンに関連する催不整脈作用や変時作用を持ちません。
歴史的には中枢性尿崩症の治療に使用されていましたが、長時間作用型の油性製剤が製造中止となったため、現在では長期管理には合成アナログであるデスモプレシン（DDAVP）が主に代用されています。
作用機序
Vasopressin exerts its effects via multiple receptor subtypes:
- V1 Receptors (Vascular Smooth Muscle): Mediates profound vasoconstriction. At high doses, it causes contraction of capillaries and small arterioles, increasing systemic vascular resistance and blood pressure. It also stimulates smooth muscle in the bladder, gallbladder, and GI tract.
- V2 Receptors (Renal Collecting Ducts): Mediates antidiuretic effects. Vasopressin binds to V2 receptors → activates adenylate cyclase → increases cAMP → promotes the insertion of aquaporin-2 channels into the luminal membrane → increases water permeability and reabsorption of solute-free water → concentrates urine and decreases urine flow.
- V3 Receptors (Pituitary): Stimulates the release of corticotropin (ACTH).
- Oxytocin & Purinergic (P2) Receptors: Minimal oxytocic effects at standard doses, but massive doses can stimulate uterine contraction.
安全性・警告
禁忌
- Known hypersensitivity to vasopressin
- Chronic nephritis until nitrogen retention is resolved to reasonable levels
- Cardiogenic shock (due to risk of myocardial ischemia)
有害事象
- Local irritation at the injection site
- Sterile abscesses
- Skin reactions
- Platelet aggregation
- Bilirubinemia
- Abdominal pain
- Hematuria
- Hypersensitivity (urticarial) reactions
- Water intoxication (with overdosage)
注意事項
Important Warnings
- Cardiovascular Disease: Use with extreme caution in patients with vascular disease or heart failure due to potent vasoconstrictive properties. High doses can cause myocardial ischemia.
- Other Conditions: Use cautiously in patients with seizure disorders or asthma.
- Pregnancy: FDA Category C. Has minimal effects on uterine contractions at usual doses, but should be used with caution in pregnant animals as animal studies have shown adverse fetal effects.
- Diagnostic Use: The water deprivation test (WDT) is contraindicated in animals that are already dehydrated or have known renal disease.
医薬品相互作用
May inhibit the antidiuretic activity of vasopressin
May inhibit the antidiuretic activity of vasopressin
May inhibit the antidiuretic activity of vasopressin
May inhibit the antidiuretic activity of vasopressin
May inhibit the antidiuretic activity of vasopressin
May potentiate the antidiuretic effects of vasopressin
May potentiate the antidiuretic effects of vasopressin
May potentiate the antidiuretic effects of vasopressin
May potentiate the antidiuretic effects of vasopressin
May potentiate the antidiuretic effects of vasopressin
May potentiate the antidiuretic effects of vasopressin
May potentiate the antidiuretic effects of vasopressin
監視
- Urine output and frequency
- Water consumption
- Urine specific gravity
- Urine osmolality
- Blood pressure and ECG (when used for shock/CPCR)
薬物動態
吸収
Destroyed in the GI tract prior to absorption; must be administered intranasally or parenterally. After IM or SC administration in dogs, aqueous vasopressin has antidiuretic activity for 2-8 hours.
分布
Distributed throughout the extracellular fluid. Apparently not bound to plasma proteins.
代謝
Rapidly destroyed in the liver and kidneys.
消失
Cleared rapidly by hepatic and renal degradation. In humans, the plasma half-life is reported to be only 10-20 minutes.
過剰投与
Water Intoxication
Overdosage of vasopressin leads to excessive water retention and subsequent water intoxication (dilutional hyponatremia).
- Early Signs: Listlessness, depression, and lethargy.
- Severe Signs: Coma, seizures, and eventually death due to cerebral edema.
Treatment:
- Mild Intoxication: Discontinue vasopressin therapy and strictly restrict water access until clinical signs resolve.
- Severe Intoxication: May require the administration of osmotic diuretics (e.g., mannitol, urea, or dextrose) with or without a loop diuretic like furosemide to rapidly excrete excess free water.
製品
製剤
- Injection: 20 pressor Units/mL
ヒト用医薬品
- Vasopressin Injection: 20 pressor Units/mL in 0.5 mL, 1 mL & 10 mL vials (Pitressin Synthetic, generic)
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store aqueous injection at room temperature; avoid freezing. For intravenous or intra-arterial infusion, it may be diluted in either 5% Dextrose in Water (D5W) or normal saline.
飼主向け情報
飼い主向け情報
- 院内専用：バソプレシンは主に獣医師が病院内で使用する注射薬です。多飲多尿を伴う特定の疾患（尿崩症など）の診断や、重度のショックや心停止時の救命救急薬として使用されます。
- 診断テスト：ペットが「水制限試験」を受ける場合、病院で厳密に監視されます。試験の最後にバソプレシンを投与し、ペットの腎臓がホルモンに反応して尿を濃縮できるかを確認します。
- 長期治療：以前は尿崩症の自宅治療に使用されていましたが、現在ではより安全で便利なデスモプレシン（DDAVP）という合成点眼薬や錠剤にほとんど置き換わっています。
- 安全性：血管を強く収縮させる作用があるため、緊急時に使用される場合は、獣医療チームがペットの心臓や血圧を注意深くモニタリングします。
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