Gastrointestinal bleeding vasopressin

Darcy M (2003) Treatment of lower gastrointestinal bleeding vasopressin infusion versus embolization. J Vase Interv Radiol 14 535-543... 

Synthetic aqueous vasopressin is a short-acting preparation for intramuscular, subcutaneous, or intravenous administration. The dose is 5-10 units subcutaneously or intramuscularly every 3-6 hours for transient diabetes insipidus and 0.1-0.5 units/min intravenously for gastrointestinal bleeding. 

There are several ways to stop gastrointestinal bleeding by catheter intervention infusion of vasoconstrictive drugs (vasopressin), embolization and intentional induction of vasospasm. 

When arginine vasopressin is used in high single doses (4—16 IU), to control upper gastrointestinal tract bleeding, gut ischemia has been reported (20). Continuous infusions at lower doses have shown changes suggestive of splanchnic hypoperfusion. 

I. V. Infusion The intravenous infusion of vasopressin (Pitressin), the preferred treatment for bleeding from esophageal varices, is at times effective in the management of diffuse gastrointestinal hemorrhage as seen in patients with leukemia and lymphoma. Vasopressin causes vasoconstriction and contraction of the bowel wall smooth muscle. It also has a weak antidiuretic effect. Once the site of bleeding has been identified, an infusion of vasopressin is started at a rate of 0.2 units/min which can be increased in 0.1 unit increments up to 0.6 units/min which is seldom used. This dose can result in intestinal myocardial and/or peripheral vascular ischemic complications. 

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