Shock is characterized by collapse of the circulatory system where vital tissues do not receive enough blood flow. The main types of shock are hypovolemic, septic, cardiogenic, and anaphylactic shock. Drugs used to treat shock include vasoconstrictors like epinephrine and norepinephrine which increase blood pressure, cardio tonic drugs like digoxin and dobutamine which increase heart contractility, and fluid replacement agents like blood, colloids, and crystalloids which replenish blood volume. Epinephrine causes vasoconstriction, increases heart rate and contractility, and dilates bronchioles. Norepinephrine also causes vasoconstriction.

1. DRUGS FOR
TREATING SHOCK
DR. SAROJ SUWAL

2. SHOCK
• Syndrome characterize by collapse of Circulatory System
Vitals tissue
doesn’t receive
enough blood to
function properly
Cell cannot carry
on normal
metabolism
Shock is a systemic state of low tissue perfusion,
which is inadequate for normal cellular respiration.

3. SYMPTOMS AND SIGNS

4. TYPES OF SHOCK
• Hypovolemic:
• Due to loss of blood
volume
• Two types
• hemorrhagic,
• non-hemorrhagic (GI or
renal losses, burns, etc.)
•

6. • Septic Shock
• Multiple organ Dysfunction due to
organism in blood
• Cardiogenic:
• Failure to pump blood to issue
• Acute myocardial infraction
resulting in massive damage to
myocardium, CHF ,Pulmonary
embolism

7. ANAPHYLACTIC SHOCK
• due to acute allergic reactions
• Due to severe reaction to allergens
• Drugs: penicillin , radio contrast, lignocaine , anesthetic drugs, iron
injectable . . etc.
• Blood transfusion
• Stings and snake bite
• New clothes
• Dusting smokes
• Suddenly climate change

9. DRUGS USED FOR SHOCK
•3 categories
•Vasoconstrictors
•Cardio Tonic Drugs
•Fluid Replacement agents

10. VASOCONSTRICTORS
• EPINEPHRINE
• NOR-EPINEPHRINE
SHOCK →BP
drop Initially
inscrease
sympathetic
Nervous System
Vasoconstriction Inscrease BP

11. EPINEPHRINE/ ADRENALINE
• Non selective adrenergic agent
• stimulates both the alpha- and beta-
adrenergic systems
• causes
• systemicVASOCONSTRICTION
• gastrointestinal relaxation,
• stimulates the HEART, and
• dilates BRONCHI and cerebral vessels.

12. Increase BP →
• due to alpha 1 receptor in smooth muscle of blood
vessels
Cardia output increase→
• due to stimulation of beta 1 receptor in hear
Airway open →
• due to stimulation of beta 2

15. NON EPINEPHRINE
• Norepinephrine is similar to adrenaline.
• chemical released from the sympathetic nervous
system
• Stress Hormone
• It works by constricting (narrowing) the blood vessels and
increasing blood pressure and blood glucose (sugar) levels.
• Norepinephrine is used to treat life-threatening low blood
pressure (hypotension)
• Has both alpha and beta one activity

18. CARDIO TONIC DRUGS
• Ionotropic agents – increase force of contraction of heart
muscles
• Digoxin
• Dobutamine
• Dopamine

19. • Dermotropic → affect tissue of heart

20. DIGOXIN
• cardiotonic glycoside obtained mainly from
Digitalis lanata
• has positive inotropic and negative
chronotropic activity
• used for
• congestive heart failure and
• supraventricular arrhythmias
• control ventricular rate

21. DOBUTAMINE
• Used in treatment of cardiogenic shock and
severe heart failure.
• Beta 1 adrenergic agent
Dobutamine
Chonotropic
Effect
Increase heart
beat forcibly
Increase in CO
maintaining blood
flow to vital
organs

22. DOPAMINE
• Released from brain
• dopamine as neurotransmitter—a chemical released by neurons
(nerve cells) to send signals to other nerve cells.

23. DOPAMINE
• Acts differently in different dose ( LOW, MEDIUM and HIGH Dose )
• Acts on dopamine, alpha and beta receptors
stimulate beta 1
receptor in
kidney
Cause
vasodilation Increase
blood flow to
kidney

24. • Low dose :
• Used for treating hypovolemic and cardiogenic shock
• Modrate dose
• Stimulates beta 1 receptor→ cause increase rate with force→
inscrease CO
• High Dose
• Stimulates alpha recetor→ vasoconstriction→ increase BP

25. FLUID REPLACEMENT
• Used to replace blood or other fluids during hypovolemic
shock
• Generally replacement done are
• Blood,
• colloids,
• crystalloids

26. BLOOD
• Whole Blood
• Blood from standard donation
• indicated for acute and massive blood loss
• Will replace plasma volume
• Supply RBC’s

28. COLLOIDS
• Used when 1/3 blood volume is lost
• Are proteins that stay suspended in blood for long period
• Draw water from body’s cells and tissues into blood vessels
• Colloids are
• Serum albumin, plasma protein fractions, dextrans

30. CRYSTALLOIDS
• IV solutions that contain electrolytes that is same as contained in
plasma
• Like colloids leave blood and enter into cell
• Used for
• replacing fluid lost
• Increase urine output
• Include
• NS, RL, Hypertonic Saline
• 5% dextrose

32. THANKS