Shock part 2 lecture Flashcards
Treatment of hypovolemic shock
___________–>Increase blood
blood transfusion
Treatment of obstructive shock
Treat underlying causes
________ or embolectomy (pulmonary embolism)
tPA
Treatment for Cardiogenic shock is increase contractility using inotropes like _________,____________)
dobutamine, milrinone
Distributive shock is caused by too much vasodilation, so we want to constrict those
We treat distributive shock with what?
vasopressors
Examples of vasopressors are phenylephrine, NE,Epi, and vasopressin
Intropes do what?
increase heart contractility, which increases stroke volume and increases cardiac output
Vasopressors increases vasoconstriction and increase TPR
Beta blocker is a negative chronotrope and inotrope because it decreases heart rate and decreased contractility
Digoxin is a positive inotrope
Vasopressors also increases cardiac output because it increases vasoconstriction–>increase preload–>increase stroke volume–>increase cardiac output–>increase blood pressure
What do you use vasopressor for?
Shock
What is being constricted? constrict both arteries and veins :)
constricting arteries can increase afterload which is bad
Vasopressors and Inotropes
Classifications:
Sympathomimetics (agents that mimic fight or flight)
Phosphodiesterase (PDE) 3 inhibitors
Vasoactive peptides (ADH)/vasopressin
The goal of vasopressor treatment?
increase TPR–>increase Blood pressure
vasopressors increase contractility, increase preload, increase afterload
some vasopressors do both
increase blood pressure, increase cardiac output, and increase TPR
Catecholamines:norepinephrine, epinephrine, dopamine
