Comprehensive Overview of Drugs Used in Shock Therapy and Management

Comprehensive Overview of Drugs Used in Shock Therapy and Management

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  DRUGS USED INTHE THERAPY OF SHOCK  SHOCK Shock is a condition in which our body's cells do not get a proper amount of O supply (hypoxia), which results in a decrease in tissue perfusion and may ₂ lead to: Organ damage Heart failure Brain stroke Necrosis Unconsciousness Shock may also lead to the death of the patient. ↓ Tissue perfusion ↓ ↓ O supply ₂ ↓ SHOCK
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  CAUSES OF SHOCK 1.Decrease in blood volume (blood supply) This may occur due to: Excessive loss of body fluids Haemorrhage – escape of blood due to rupture of blood vessels Severe burns Dehydration Allergic reactions Diarrhoea Poisoning, etc. SIGNS AND SYMPTOMS OF SHOCK Nausea and vomiting Pale skin due to lack of blood supply Shortness of breathing Cold hands and feet
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   TYPES OFSHOCK 1. Hypovolemic shock 2. Cardiogenic shock 3. Anaphylactic shock 4. Septic shock 5. Neurogenic shock 1. HYPOVOLEMIC SHOCK  Hypo = Low & Volemic = Volume  Therefore: Hypovolemic = Low volume of blood  It is a type of shock caused due to a low volume of blood.  Causes Blood loss Electrolyte loss Trauma Diarrhoea Haemorrhage Vomiting, etc.
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  Mainly due to: Hypovolemia ↓ ↓Blood volume ↓ ↓ Blood supply  Treatment  Saline  Plasma  IV fluids  Plasma expanders Plasma expanders Plasma expanders are those agents which have a relatively high molecular weight and help to provide or expand plasma volume by increasing the osmotic pressure.
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  2. CARDIOGENIC SHOCK Cardiogenicshock is a type of shock caused due to heart disease, especially: Myocardial infarction (MI) & Angina pectoris Heart disease / Myocardial infarction / Angina pectoris ↓ Decrease in working of the heart ↓ Heart failure / Cardiogenic shock ↓ ↓ Cardiac output ↓ ↓ Total peripheral perfusion Further effect ↓ O supply ₂ ↓ ↓ Blood supply ↓ Pain and necrosis Treatment  Vasodilators (Nitroglycerin)  O administration ₂  Pain relievers
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  3. ANAPHYLACTIC SHOCK Anaphylactic shock is a type of shock caused due to a severe allergic reaction, such as hypersensitivity. Allergen ↓ Release of histamine and other mediators ↓ Anaphylactic shock  Treatment  Epinephrine – drug of choice / first-line treatment  O administration ₂  Corticosteroids
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  4. SEPTIC SHOCK Septic shock is caused due to some bacterial infection, such as:  Gram-positive bacterial infection  Gram-negative bacterial infection Bacterial infection ↓ Endotoxin liberation ↓ SEPTIC SHOCK  This may result in:  Decrease in venous return  Decrease in cardiac output  Treatment  Antibiotic therapy  O administration ₂  Corticosteroids in large amounts 5. NEUROGENIC SHOCK Neurogenic shock is caused due to damage to the nervous system. Treatment :- Mainly epinephrine / appropriate sympathomimetic drugs
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  DRUGS USED INSHOCK – CLASSIFICATION 1. SYMPATHOMIMETICS Sympathomimetic drugs are those drugs which copy the action of the sympathetic nervous system and give similar action. They are mainly used in: Anaphylactic shock, Septic shock, Cardiogenic shock Important drugs include: Epinephrine, Norepinephrine  EPINEPHRINE Epinephrine binds to both: α (Alpha) receptors & β (Beta) receptors  β - ₁ Receptor action Positive inotropic effect ↓ ↑ Force of cardiac contraction ↓ ↑ Cardiac output (CO)
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  Other effects  Increasein heart rate  Increase in force of contraction  Helps to improve circulation It is mainly useful in:  Anaphylactic shock  Other selected shock conditions as indicated  NOREPINEPHRINE Norepinephrine acts mainly on: α-receptors & β - ₁ receptors β - ₁ Receptor Positive inotropic effect ↓ ↑ Force of contraction ↓ ↑ Cardiac output It is used in conditions requiring restoration of blood pressure and circulation, including selected cases of septic shock.
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  2. ALPHA BLOCKERS Examples: Prazosin, Phenoxybenzamine, etc.  Mechanism Block α-receptors ↓ ↓ Vasoconstriction ↓ ↑ Vasodilation  These drugs are mentioned in relation to improving vascular circulation in appropriate cardiovascular conditions. 3. OXYGEN (O ) ₂  Oxygen administration is used in almost all types of shock.  Effect Administration of O₂ ↓ ↑ O supply to tissues ₂ ↓ ↑ Tissue perfusion / tissue oxygenation
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  4. PLASMA EXPANDERS Plasma expanders are mainly used to treat: Hypovolemic shock  They act by: Plasma expander ↓ ↑ Osmotic pressure ↓ ↑ Plasma volume ↓ ↑ Blood volume ↓ ↑ Blood supply Examples:- Dextran, etc. 5. CORTICOSTEROIDS  Corticosteroids are mainly used in: Anaphylactic shock Cardiogenic shock Septic shock  They are mentioned as helping through their effects on inflammatory and allergic reactions.