Shock Syndromes Flashcards
What are the causes of hypovolemic shock?
- loss of intravascular fluids
- surgery
- trauma
- hemorrhage
- severe dehydration
What are the causes of distributive shock?
- loss of vascular tone
- sepsis
- spinal cord injury
- anaphylaxis
What are the causes of cardiogenic shock?
- loss of pump function
- acute MI\
- valve abnormality
- arrhythmias
- HF
What are the causes of obstructive shock?
- extra cardiac obstruction to blood flow
- tension pneumothorax
- cardiac tamponade
- PE
What does B1 activation on the heart result in?
- positive inotrope- increase force of contraction
- chronotrope- increase HR
What does B2 activation on the lungs and vasculature result in?
- bronchodilation
- vasodilation- decrease afterload/ SVR
What does a1 activation on the vasculature result in?
vasoconstriction- increased afterload/ SVR
What does V1 activation on the vasculature result in?
vasoconstriction- increased afterload/ SVR
What does angiotensin 1 activation on the arterioles result in?
vasoconstriction- increased afterload/ SVR
What activity does low dose (<2mcg/kg) DA have as a vasopressor?
mostly B1
What activity does moderate dose (2-10 mcg/kg) DA have as a vasopressor?
mostly B1;
some a1
What activity does high dose (>10mcg/kg) DA have as a vasopressor?
B1 and a1
What kind of vasopressor activity does NE have?
mostly a1;
some B1
What vasopressor is preferred in sepsis?
NE
What kind of vasopressor activity does phenylephrine have?
strong a1
What kind of vasopressor activity does Epi have?
strong B1;
some a1 and B2
What vasopressor is preferred for anaphylactic shock?
Epi
What agents are used to treat extravasation of vasopressors?
Phentolamine
Nitropaste
Terbutaline
What activity does the inotrope Dobutamine have?
mostly B1;
B2
What activity does the inotrope Milrinone have?
PDE
What is the overall effect of inotropes?
vasodilation and inotropic properties
