바소프레신

호르몬 / 항이뇨제 / 혈관수축제

**바소프레신(Vasopressin)**은 항이뇨 호르몬(ADH)으로도 알려져 있으며, 시상하부에서 합성되어 뇌하수체 후엽에 저장되는 내인성 펩타이드 호르몬입니다. 수의학에서는 다음과 같은 중요한 역할을 합니다: * **진단제**: 주로 수분 제한 검사에서 중추성 요붕증과 신성 요붕증을 감별하는 데 사용됩니다. * **응급 및 중환자 치료**: 혈관확장성 쇼크의 보조 치료 및 심폐뇌소생술(CPCR) 중 사용이 점차 증가하고 있습니다. > **임상 핵심**: 중증 쇼크나 심정지(심실 무수축/무맥성 전기 활동) 상태에서 바소프레신은 에피네프린보다 뚜렷한 장점을 제공합니다. 산증 환경에서도 강력한 혈관 수축을 유도하고, 관상동맥 및 신장 혈관을 보존하여(심근 관류 개선) 카테콜아민과 관련된 부정맥 유발 및 변시성 부작용이 없습니다. 과거에는 중추성 요붕증 치료에 사용되었으나, 지속형 오일 기반 제제의 단종으로 인해 현재 장기 관리에는 주로 합성 유사체인 **데스모프레신(DDAVP)**으로 대체되었습니다.

작용 기전: 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.

동물 종별 용량

Cats

Diagnostic agent (after water deprivation test) · 0.5 U/kg IM · IM · Once · Empty bladder and determine specific gravity at 30, 60, and 120 minutes after administration.
Adjunctive treatment of vasodilatory shock (unresponsive to fluids/catecholamines) · 0.01-0.04 Units/minute IV · IV · CRI
CPCR (pulseless electrical activity or ventricular asystole) · 0.2-0.8 Units/kg, IV once · IV · Once · May be beneficial for myocardial and cerebral blood flow.

Dogs

Diagnostic agent (Exogenous vasopressin test after water deprivation test) · 2.5 mU/kg IV over one hour · IV · Once · 1 hour · 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) · 0.01-0.04 Units/minute IV · IV · CRI · 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) · 0.2-0.8 Units/kg, IV once · IV · Once · May be beneficial for myocardial and cerebral blood flow.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

IVIMSC

금기

Known hypersensitivity to vasopressin
Chronic nephritis until nitrogen retention is resolved to reasonable levels
Cardiogenic shock (due to risk of myocardial ischemia)

이상반응

Local irritation at the injection site
Sterile abscesses
Skin reactions
Platelet aggregation
Bilirubinemia
Abdominal pain
Hematuria
Hypersensitivity (urticarial) reactions
Water intoxication (with overdosage)

약물 상호작용

Alcohol · May inhibit the antidiuretic activity of vasopressin
Demeclocycline · May inhibit the antidiuretic activity of vasopressin
Epinephrine (large doses) · May inhibit the antidiuretic activity of vasopressin
Heparin · May inhibit the antidiuretic activity of vasopressin
Norepinephrine (large doses) · May inhibit the antidiuretic activity of vasopressin
Antidepressants, Tricyclic · May potentiate the antidiuretic effects of vasopressin
Carbamazepine · May potentiate the antidiuretic effects of vasopressin
Chlorpropamide · May potentiate the antidiuretic effects of vasopressin
Clofibrate · May potentiate the antidiuretic effects of vasopressin
Fludrocortisone · May potentiate the antidiuretic effects of vasopressin
Phenformin · May potentiate the antidiuretic effects of vasopressin
Urea · May potentiate the antidiuretic effects of vasopressin

모니터링

Urine output and frequency
Water consumption
Urine specific gravity
Urine osmolality
Blood pressure and ECG (when used for shock/CPCR)

과용량

### 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.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.