OnlineMedEd: Intern Content - "Shock II"

Question 1

The pure vasoconstrictors (given for types of shock that are due to decreased SVR like neurogenic and anaphylactic) are ______________.

Answer 1

phenylephrine, vasoephrine, and epinephrine

Question 2

The two ino-constrictors are ____________.

Answer 2

dopamine (which has more constriction) and levophedrine (more inotropy)

Question 3

Trials show that ____________ has less tachyarrhythmia than dopamine.

Answer 3

levophedrine

Question 4

_____________ is the best in septic shock.

Answer 4

Levophedrine

Question 5

The ino-dilators are _______________.

Answer 5

dobutamine and milrinone

Question 6

In which patients would you use ino-dilators?

Answer 6

CHF

They have too much SVR and not enough systolic ejection.

Question 7

If someone has shock from a GI bleed, which pressor should you give them?

Answer 7

Trick question: none

Your body ramps up SVR when you bleed, so SVR is already increased. You need to give fluids to replace the low preload that is the cause of their shock.

Question 8

Why might you give milrinone and phenylephrine or dobutamine and levophredrine?

Answer 8

If your patient has CHF and needs inotropic support you need to give them milrinone or dobutamine. These agents both cause vasodilation (they are the “ino-dilators”). You can then give SVR agents to increase tone.