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Ornipressin is a synthetic analog of vasopressin, where the eighth amino acid residue is substituted with ornithine. It is an oligopeptide and acts primarily as a potent vasoconstrictor and hemostatic agent. Its mechanism of action involves agonism at the vasopressin V1A receptor, leading to vascular smooth muscle contraction and resulting in intense vasoconstriction. It also exhibits antidiuretic effects via activation of V2 receptors in the renal collecting ducts, though less potently than native vasopressin. Clinically, it has been used to control bleeding during surgery (hemostasis), manage esophageal variceal bleeding, and as rescue therapy in cases of refractory vasodilatory shock or functional renal failure associated with advanced liver cirrhosis. Ornipressin was introduced in 1971 and has been approved for use in countries such as Germany, Switzerland, New Zealand, and Australia[1][4][5][6].
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