Pharmacologic Actions of Drugs Used in the Treatment of Shock Syndromes

Question 1

Hypovolemic
Cardiogenic
Obstructive shock

Answer 1

Loss of blood or fluid leads ot low preload and low CO

Loss of function leads to low output

Extracardiac compromoise of blood flow through heart elads to low CO

Question 2

Septic

Answer 2

Maldistribution of BF (arterial vasodilation with reduced systemic sreisstance)

Low preload due to neodilation and cpaillary leakage of fluid…heart compensates by inc inotropy and HR

Inadequate cardiac function superveneces

Question 3

Positive inotropic agents

Answer 3

Dobutamine
Dopamine
Epineprhine
Norepineprhine

Inc CO through cAMP

Question 4

Vasoconstrictos

Answer 4

Dopamine
Norepineprhine
Epineprhine

Vascular smooth muscle contractio nand inc in TPR and BP

IP3 mediated

Question 5

Vasopressin

Answer 5

Induces IP3 mediated vasoconstriction and inc in TPR and BP

Question 6

Dopamine

Answer 6

DA1 - renal vasodilation…maintain renal perfusion in advanced HF or cardiogenic shcok

Beta 1 - pos inotropic would inc CO and be useful in cardiogenic shokc…limitedb y tachycardia

Alpha 1 - vasoconstriction not beneficial in heart failure but could be of benefit in vasodilatory shock syndromes where there is a dec in vascular resistance (think septic shock)

Question 7

Dobutamine

Answer 7

Beta 1 - pos intorptic…inc CO in cardiogenic

Alpha 1 - vasoconstrcition

Beta 2 - vasodilation

Overall effect is vry modest degree of vasodilation

Question 8

Epineprhine

Answer 8

Beta1 - inotropic..inc CO in cardiogenic

Beta 2 - vasodilation

Alpha 1 - vasoconstriction

Inc in PVR from alpha would inc BP so would help where dec in vascular resistance - like septic shock

Question 9

Norepineprhine

Answer 9

Beta 1 - CO

Alpha 1 - vasoconstrction…good for septic shcok

Question 10

AVP

Answer 10

Vasoconstriction and inc BP in vasodilatory types of shcok such as sepsis