title: Vasopressin treatment of verapamil toxicity in the porcine model.
abstract: BACKGROUND
  Vasopressin is a novel vasopressor agent used for intractable hypotension. There is little published data available on its use in the poisoned patient. We performed a randomized, controlled, blinded trial in a porcine model to study the effects of vasopressin infusion on mean arterial pressure after verapamil poisoning.
  
  
  METHODS
  Eighteen anesthetized monitored swine received a verapamil infusion of 1 mg/kg/hr until the mean arterial pressure (MAP) had decreased to 70% of baseline. At this time, a continuous infusion of either vasopressin (0.01 U/kg/min) or an equal volume of normal saline was initiated. The swine were monitored for 60 minutes after initiation of the study infusion. The primary outcome was MAP.
  
  
  RESULTS
  There was no statistically significant difference between the two groups in MAP, cardiac output or systemic vascular resistance. One half (four of eight) of the animals in the vasopressin group died, compared with 20% (two of ten) of those in the saline group.
  
  
  CONCLUSIONS
  Vasopressin infusion decreased the survival of verapamil-poisoned swine when compared to those treated with saline alone in this experimental model.
authors: Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA. JDave.Barry@us.army.mil
authors: J Dave
authors: JD
authors: Barry
authors: Dave
authors: D
authors: Durkovich
authors: Lee
authors: L
authors: Cantrell
authors: William
authors: W
authors: Richardson
authors: Tri
authors: T
authors: Tong
authors: Steve
authors: S
authors: Offerman
authors: Richard F
authors: RF
authors: Clark
authors: David A
authors: DA
authors: Tanen
authors: Saralyn
authors: S
authors: Williams
mesh_terms: D000818:Animals; D000931:Antidotes / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D004195:Disease Models, Animal; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D008136:Longevity / Q000187:drug effects; D008297:Male; D011041:Poisoning / Q000188:drug therapy* / Q000378:metabolism; D016037:Single-Blind Method; D013552:Swine; D014662:Vasoconstrictor Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000493:pharmacokinetics / Q000506:poisoning*; D014667:Vasopressins / Q000493:pharmacokinetics / Q000627:therapeutic use*; D014700:Verapamil / Q000493:pharmacokinetics / Q000506:poisoning*
chemical_list: D000931:Antidotes; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D014667:Vasopressins; D014700:Verapamil