V1 agonist
V1 vasopressin receptor agonist
- Vasoconstriction → ↑ blood pressure
- ↓ splanchnic flow → ↓ portal pressure → ↓ variceal bleeding
- Excess vasoconstriction → digital, mesenteric, myocardial ischemia
- The pressor arm of vasopressin, distinct from renal V2 water handling
- Glycogenolysis → ↑ glucose
- Platelet aggregation
- Circadian regulation
- AVP is rhythmically expressed in the suprachiasmatic nucleus (SCN) = master circadian clock ◇ V1 receptor activation peaks during subjective daytime
- ACTH release from pituitary → increased cortisol
- Works synergistically with CRH to promote stress response
- Behavioral entrainment (meal time, etc.)
- Insulin and glucagon secretion
Drugs with this mechanism (2)
- Terlipressin — Vasopressin analog for hepatorenal syndrome; respiratory failure limits use.
- Vasopressin — Antidiuretic hormone; a vasopressor in shock and treatment for diabetes insipidus.
Self-check
- How does reduced splanchnic flow affect portal pressure?
Lowers it. - What can excessive V1 vasoconstriction cause in the digits?
Ischemia.
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