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If it is desired Post Date: Sun, 12 Oct 2008 17:14:11 +0000 Pressor Action. Despite its unfortunately chosen name, vasopressin should not be employed as a pressor agent. If it is desired to produce systemic peripheral vasoconstriction, preference should be given to ap-propriate sympathomimetic amines that can increase peripheral resistance without reducing coronary blood flow. Autor of the post: Undefined Only a moderate rise Post Date: Sun, 12 Oct 2008 16:55:26 +0000 However, it has been proposed that a justifiable exception may be made for the use of vasopressin as an adjunct in the control of bleeding esophageal varices and during abdominal surgery in patients with portal hypertension. When large doses (20 units in 5 minutes) are infused in normal subjects or in patients with cirrhosis and portal hypertension, there is a marked decrease in portal blood flow and pressure lasting approximately 30 minutes (Edmunds and West, 1962). Only a moderate rise in arterial pressure occurs. Autor of the post: Undefined After its parenteral administration, continuous Post Date: Sun, 12 Oct 2008 16:43:42 +0000 This effect on portal circulation is attributable to marked splanchnic vasoconstriction. An inactive "hormogen," triglycyl vasopressin, glypressin, is under study for such use. After its parenteral administration, continuous conversion to the active octapeptide by the liver results in sustained plasma concentrations that are claimed to provide splanchnic vasoconstriction with minimal effects on other vascular beds. Autor of the post: Undefined The advantage claimed Post Date: Sun, 12 Oct 2008 16:24:53 +0000 The use of phenylalanine2-^ sine8 vasopressin, known as octapressin, felypressin, or PLV-II, as a local hemostatic agent has been widely investigated because of its higher ratio of pressor to other activi-ties. It has also been used in place of epinephrine to retard the absorption of local anesthetics. The advantage claimed is that it does not cause cardiac effects in the doses used for these purposes. Autor of the post: Undefined Posterior pituitary extract or vasopressin Post Date: Sun, 12 Oct 2008 16:10:42 +0000 The preparation is not yet available in the United States.Intestinal Action. Posterior pituitary extract or vasopressin has been used in the relief of intestinal paresis and distention. Autor of the post: Undefined Combined therapy may result Post Date: Sun, 12 Oct 2008 15:55:41 +0000 A dose of 5 to 10 units is given by intramuscular injection. However, it should be emphasized that the successful treatment of intestinal distention often calls for varied procedures, in-cluding suction decompression and drugs such as neostigmine. Combined therapy may result in addi-tive effects. Autor of the post: Undefined Following the injection of large Post Date: Sun, 12 Oct 2008 15:44:35 +0000 The action of vasopressin has also been utilized prior to cholecystography in order to remove gas from the bowel.Untoward Reactions and Contraindica-tions. Following the injection of large doses of posterior pituitary extract or vasopressin, marked facial pallor as a result of cutaneous vasoconstriction is commonly observed. Autor of the post: Undefined Most serious, however Post Date: Sun, 12 Oct 2008 15:33:26 +0000 In-creased intestinal activity is likely to cause nausea, belching, cramps, and an urge to defecate. Women are apt to experience uter-ine cramps of a menstrual character. Most serious, however, is the effect on the coronary circulation. Autor of the post: Undefined The use of chlorothiazide Post Date: Sun, 12 Oct 2008 15:14:11 +0000 Individuals suffering from vascu-lar disease, especially disease of the coronary arteries, should never receive vasopressin, except in the small doses needed for the treatment of diabetes insipidus. Sometimes even these small doses may cause difficulty in a patient who is subject to anginal attacks. The use of chlorothiazide or its congeners is indicated in such patients. Autor of the post: Undefined Their clinical use for Post Date: Sun, 12 Oct 2008 15:03:46 +0000 When posterior pituitary powder is applied to the nasal mucosa, local irritation is common and hypersensitivity reactions may occur.BENZOTHIADIAZIDESChlorothiazide and other benzothiadiazide (thiazide) diuretics paradoxically cause a re-duction in the polyuria of patients with dia-betes insipidus (Crawford and Kennedy, 1959). Their clinical use for this purpose is now well established. 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