Drugs to Treat Shock

Question 1

What is always the first line therapy for septic shock?

Answer 1

Crystalloid fluid resuscitation

Question 2

What is the immediate treatment for anaphylactic shock?

What are all the receptors hit with this treatment and what do they cause?

Answer 2

1) Epinephrine
2) β1 to increase myocardial contractility
3) α1 and α2 to increase vascular tone in organs
4) β2 for bronchodilation

Question 3

What is the standard treatment for most cases of shock due to blood loss?

At what amount of blood loss is blood transfusion absolutely required?

Answer 3

1) Crystalloid fluid resuscitation

2) ≥ 2000 mL

Question 4

What drugs should be used for cardiogenic shock?

Which is considered superior?

What is used in refractory shock/systolic heart failure when low cardiac output despite adequate filling pressure?

Answer 4

1) NE and DA
2) NE
3) Dobutamine

Question 5

After fluid resuscitation what should be given to patients undergoing septic shock?

Answer 5

Broad spectrum antibiotics

Question 6

What vasopressor drug is the first line Tx for septic shock?

What can be added to this or substituted as first line choice?

Answer 6

1) NE

2) EPI

Question 7

What can be added to NE for the Tx of septic shock but is not a first line choice?

What is used only as a substitute for NE if there is bradycardia?

What is not recommended unless NE causes arrhythmias or continue to have high CO with low TPR?

Answer 7

1) Vasopressin
2) Dopamine
3) Phenylephrine

Question 8

What is important to administer for septic shock in low doses to improve shock reversal?

Answer 8

Corticosteroids