Question - Since its resurgence as a drug used in the treatment of some cases severe sepsis reports of extravasation and skin necrosis due to vasopressin have appeared in the literature. What is the recommended treatment for vasopressin extravasation?
Answer - The cited article notes “Treatment with local nitroglycerin may be attempted because it is often administered systemically for the prevention of the ischemic manifestations of high-dose vasopressin. Phentolamine or terbutaline may be useful but only on the basis of their intrinsic ability to induce vasodilation, as opposed to direct antagonism of vasopressin’s pharmacologic effects.” (Reynolds PM et al. Management of extravasation injuries: A focused evaluation of noncytotoxic medications. 2014 Pharmacotherapy 34(6): 617-632)