Classifications: hormones and synthetic substitutes; pituitary (antidiuretic)
Pregnancy Category: X
Assessment & Drug Effects
- Monitor infants and children closely. They are more susceptible to volume disturbances (such as sudden reversal of polyuria) than adults.
- Establish baseline data of BP, weight, I&O pattern and ratio. Monitor BP and weight throughout therapy. (Dose used to stimulate diuresis has little effect on BP.) Report sudden changes in pattern to physician.
- Be alert to the fact that even small doses of vasopressin may precipitate MI or coronary insufficiency, especially in older adult patients. Keep emergency equipment and drugs (antiarrhythmics) readily available.
- Check patient’s alertness and orientation frequently during therapy. Lethargy and confusion associated with headache may signal onset of water intoxication, which, although insidious in rate of development, can lead to convulsions and terminal coma.
- Monitor urine output, specific gravity, and serum osmolality while patient is hospitalized.
- Withhold vasopressin, restrict fluid intake, and notify physician if urine-specific gravity is <1.015.
Patient & Family Education
- Be prepared for possibility of anginal attack and have coronary vasodilator available (e.g., nitroglycerin) if there is a history of coronary artery disease. Report to physician.
- Measure and record data related to polydipsia and polyuria. Learn how to determine specific gravity and how to keep an accurate record of output. Understand that treatment should diminish intense thirst and restore undisturbed normal sleep.
- Avoid concentrated fluids (e.g., undiluted syrups), since these increase urine volume.
- Do not breast feed while taking this drug without consulting physician