Drugs to treat Shock Flashcards
If a patient is Hypotensive, what should you give them? And what is the one time you should NOT give them that?
Crystalloid (IV saline) - 30 mL/kg
– Do NOT give if they are in Cardiogenic Shock
If a patient is Hypotensive, what should you give them? And what is the one time you should NOT give them that?
Crystalloid (IV saline) - 30mL/kg
– Do NOT give if they are in Cardiogenic Shock
Crystalloid increases the cardiac filling pressure, what is the goal for the JVP?
10-12
Epinephrine MOA
(+) alpha and beta receptors
= vasoconstriction, elevates contractility and broncodilates
If a patient presents with Anaphylactic Shock, what should be given immediately?
Epinephrine via IM
If a patient presents with Anaphylactic shock, what should be given immediately and what may or may not be added?
Epinephrine
- +/- Antihistamine
- +/- Inhaled Albuterol
Hypovolemic Shock due to Blood loss < 15% treatment?
Crystalloid
Hypovolemic Shock due to blood loss of 15-30% treatment?
Crystalloid
Hypovolemic Shock due to blood loss of 30-40% and the patient is anxious/confused, what is the treatment?
Crystalloid +/- blood
Hypovolemic Shock due to > 40% blood loss where the patient is confused/lethargic treatment?
Crystalloid + Blood!
Are drugs generally required when treating hypovolemic shock due to blood loss?
No
List Vasopressors/Inotropes available to treat shock
Dopamine Norepinephrine Epinephrine Phenylephrine Dobutamine Vasopressin
Dopamine MOA?
(+) beta receptors are low doses and then (+) alpha receptors are high doses
Norepinephrine MOA?
(+) alpha and beta 1 receptors
Epinephrine MOA?
(+) alpha and beta receptors
Dobutamine MOA?
(+) beta 1 receptors to increase HR and contractility with vasodilation in the periphery
Phenylephrine MOA?
(+) alpha receptors ONLY to elevate BP and decrease HR/contractility
Where does Vasopressin come from?
Posterior pituitary hormone
What receptors does Vasopressin (+) and what is the result?
V1 = Vasoconstriction V2 = Anti-diuretic in kidney
When treating Cardiogenic Shock, what is the best drug?
Norepinephrine
When treating Cardiogenic Shock, what is the best drug to use and what is it better than and why?
Norepinephrine
– Better than Dopamine because Dopamine causes arrhythmias and does not preserve renal function
When treating Cardiogenic Shock, what can be used when the cardiac output is low despite adequate filling pressure?
Dobutamine
With Septic Shock, prompt administration of ____ should be given
Broad-based Antibiotics
What is the 1st line of choice when treating Septic Shock?
Norepinephrine
What can be added or substituted for Norepinephrine when treating Septic Shock?
Epinephrine
What else besides Epinephrine can be added to Norepinephrine when treating Septic Shock?
Vasopressin
What is the 1st line of choice when treating Septic Shock?
Norepinephrine
When treating Septic Shock, if there is bradycardia, what can be substituted for the Norepinephrine?
Dopamine
When is Phenylephrine recommended for Septic Shock?
When Norepinephrine is causing arrhythmias
At low doses, what can improve septic SHOCK reversal?
Corticosteroids
At low doses, what can improve septic SHOCK reversal?
Corticosteroids
For Obstructive Shock, the treatment is dependent on?
The cause
Tension pneumothorax causing Obstructive Shock treatment?
Needle decompression and chest tube placement
Cardiac tamponade causing Obstructive Shock treatment?
Pericardiocentesis
Pulmonary Embolism causing Obstructive Shock treatment?
Anticoagulants
What can treat acute and recurrent Pericarditis?
NSAIDs and Colchicine
- NSAIDs: ibuprofen, aspirin, naproxen
MOA for Colchicine?
(-) Microtubule formation and white cell migration
What can treat acute and recurrent pericarditis?
NSAIDs and Colchicine
- NSAIDs: aspirin, naproxen, ibuprofen
If the first line of treatment combo for pericarditis does not work, what can you try?
Corticosteroids
