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The coronary vessels are not Post Date: Mon, 13 Oct 2008 0:22:31 +0000 It is neither antagonized by adrenergic blocking agents nor prevented by vascular denervation. Circulation in the skin and the gastrointestinal tract is markedly reduced. The coronary vessels are not exempt from the vasoconstrictor effects of vasopressin, and pulmonary arterial pressure also rises. Autor of the post: Undefined When the efficiency of baroreceptor Post Date: Mon, 13 Oct 2008 0:10:11 +0000 The effects on blood pressure are conditioned by the reactivity of baroreceptor reflexes. Therefore, in normal conscious subjects, very large amounts of vasopressin must be administered to produce a marked and sustained rise in blood pressure. When the efficiency of baroreceptor reflexes is depressed by anesthesia, smaller amounts of the hormone elicit pressor responses. Autor of the post: Undefined However, the rate of administration Post Date: Sun, 12 Oct 2008 23:55:09 +0000 The blockade of autonomic vaso-motor and cardioregulatory outflow by ganglionic blocking agents causes a marked increase in sensi-tivity to the pressor effects. Wagner and Braunwald (1956) have observed that patients with inherent defects in sympathetic outflow are strikingly sensitive to ADH. However, the rate of administration re-quired to produce a rise in blood pressure in such subjects is still larger than that required to produce a maximal renal effect. Autor of the post: Undefined Aside from the reflex responses Post Date: Sun, 12 Oct 2008 23:36:59 +0000 It seems physiologically un-likely that ADH plays any essential role in the regu-lation of peripheral resistance.The effects of vasopressin on the heart are indirect and are the result of decreased coro-nary blood flow and of reflexly induced al-terations in vagal and sympathetic tone. Aside from the reflex responses occasioned by the elevation of blood pressure, the effects observed are characteristic of myocardial ischemia. Autor of the post: Undefined The cardiac actions Post Date: Sun, 12 Oct 2008 23:20:14 +0000 The effects of ADH on the coronary blood flow can readily be demonstrated in man, provided large doses are employed. In pa-tients with coronary insufficiency, ECG changes similar to those observed after exer-cise can be observed. The cardiac actions of the hormone are of more than academic in-terest. Autor of the post: Undefined Other Smooth Muscle Post Date: Sun, 12 Oct 2008 23:06:26 +0000 Some patients with coronary insuffi-ciency experience anginal pain even in re-sponse to the relatively small amounts of ADH required to control diabetes insipidus (see below). ADH-induced myocardial ische-mia has led to severe reactions and even death (see Slotnick and Teigland, 1951).Other Smooth Muscle. Autor of the post: Undefined Motility of the bowel Post Date: Sun, 12 Oct 2008 22:52:10 +0000 The effects of ADH on smooth muscle also occur in the enteric tract. The response is elicited only by large doses (5 to 20 units). Motility of the bowel is markedly increased. Autor of the post: Undefined The smooth muscle Post Date: Sun, 12 Oct 2008 22:41:37 +0000 Peri-staltic activity rather than tone is increased, and, therefore, the propulsive movements are greatly en-hanced. The effect is greater on the large than on the small bowel. The smooth muscle of the uterus is stimulated by large doses of ADH at all stages of the menstrual cycle and during gestation, when large doses are administered (see Chapter 42). Autor of the post: Undefined ADH in aqueous solution may Post Date: Sun, 12 Oct 2008 22:27:39 +0000 Absorption, Fate, and Excretion. When ADH, lypressin, and their congeners are given orally, they are quickly inactivated by trypsin, which cleaves the 8-9 peptide link. ADH in aqueous solution may be given by the intravenous, intramuscular, or subcuta-neous route and by the nasal insufflation of powders or sprays. Autor of the post: Undefined Repository forms, such as vaso-pressin Post Date: Sun, 12 Oct 2008 22:14:08 +0000 Due to rapid inactivation, the effects are brief after intravenous admin-istration unless the hormone is given by con-tinuous infusion. After intramuscular or sub-cutaneous injection, the effects last only a few hours. Repository forms, such as vaso-pressin tannate in oil, are effective for 24 to 48 hours after subcutaneous or intramuscular injection. 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