血管加壓素 / 抗利尿激素
Vasopressin
Arginine vasopressin / Antidiuretic hormone (ADH)
別名: Pitressin · Neo-Lidocaton · Pressyn · ADH · Antidiuretic hormone · 8-arginine vasopressin · beta-hypophamine
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
血管加壓素 (Vasopressin)，又稱抗利尿激素 (ADH)，是一種在下視丘合成並儲存於腦下垂體後葉的內源性胜肽荷爾蒙。在獸醫學中，它具有幾個關鍵作用：
- 診斷試劑：主要用於限水試驗中，以區分中樞性與腎性尿崩症。
- 急診與重症照護：越來越多被用作血管擴張性休克及心肺腦復甦術 (CPCR) 的輔助治療。
臨床要點：在嚴重休克或心搏驟停（心室性心搏停止/無脈性電氣活動）的情況下，血管加壓素比腎上腺素具有明顯優勢。即使在酸中毒環境中，它也能引起強烈的血管收縮，並能保留冠狀動脈和腎臟的血管系統（改善心肌灌注），且不具有與兒茶酚胺相關的致心律不整和變時性副作用。
過去曾用於治療中樞性尿崩症，但由於長效油性製劑已停產，目前長期管理已大多被合成類似物 去氨加壓素 (Desmopressin, DDAVP) 所取代。
作用機轉
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.
安全性與警告
禁忌症
- Known hypersensitivity to vasopressin
- Chronic nephritis until nitrogen retention is resolved to reasonable levels
- Cardiogenic shock (due to risk of myocardial ischemia)
不良反應
- 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.
藥物交互作用
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
監測
- Urine output and frequency
- Water consumption
- Urine specific gravity
- Urine osmolality
- Blood pressure and ECG (when used for shock/CPCR)
藥物動力學
吸收
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.
分佈
Distributed throughout the extracellular fluid. Apparently not bound to plasma proteins.
代謝
Rapidly destroyed in the liver and kidneys.
排除
Cleared rapidly by hepatic and renal degradation. In humans, the plasma half-life is reported to be only 10-20 minutes.
過量
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.
可用產品
劑型
- Injection: 20 pressor Units/mL
人用標示
- Vasopressin Injection: 20 pressor Units/mL in 0.5 mL, 1 mL & 10 mL vials (Pitressin Synthetic, generic)
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
寵物主人指引
- 僅限醫院使用：血管加壓素是一種注射藥物，主要由獸醫師在醫院環境中使用。它用於診斷特定類型的過度飲水/排尿疾病（如尿崩症），或在嚴重休克或心搏驟停時作為救命的急救藥物。
- 診斷測試：如果您的寵物正在進行「限水試驗」，牠們將在醫院接受密切監測。在測試結束時會給予血管加壓素，以觀察寵物的腎臟是否能對該荷爾蒙產生濃縮尿液的反應。
- 長期治療：雖然過去曾在家中使用血管加壓素治療尿崩症，但現在已大多被一種更安全、更方便的合成滴劑或錠劑 去氨加壓素 (DDAVP) 所取代。
- 安全性：因為它會強烈收縮血管，如果在緊急情況下使用，您的獸醫團隊將會密切監測寵物的心臟和血壓。
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