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Drugs for treating shock

This document discusses drugs used for treating shock. It describes different types of shock including hypovolemic, septic, cardiogenic, and anaphylactic shock. It then discusses three categories of drugs used to treat shock: vasoconstrictors like epinephrine and norepinephrine which increase blood pressure, cardio tonic drugs like digoxin, dobutamine, and dopamine which increase heart function, and fluid replacement agents like blood, colloids, and crystalloids which replace lost fluids. Epinephrine causes vasoconstriction, increases heart rate and output, and dilates airways. Norepinephrine also causes vasoconstriction. Digoxin increases heart contraction force while

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DRUGS FOR TREATING SHOCK DR. SAROJ SUWAL
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.
SYMPTOMS AND SIGNS
TYPES OF SHOCK • Hypovolemic: • Due to loss of blood volume • Two types • hemorrhagic, • non-hemorrhagic (GI or renal losses, burns, etc.) •
• 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
ANAPHYLATIC 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
DRUGS USED FOR SHOCK •3 categories •Vasoconstrictors •Cardio Tonic Drugs •Fluid Replacement agents
VASOCONSTRICTORS • EPINEPHRINE • NOR-EPINEPHRINE SHOCK BP drop Initially inscrease sympathetic Nervous System Vasoconstriction Inscrease BP
EPINEPHRINE/ ADRENALINE • Non selective adrenergic agent • stimulates both the alpha- and beta- adrenergic systems • causes • systemic VASOCONSTRICTION • gastrointestinal relaxation, • stimulates the HEART, and • dilates BRONCHI and cerebral vessels.
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
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
CARDIO TONIC DRUGS • Ionotropic agents – inscrease force of contraction of heart muscles • Digoxin • Dobutamine • Dopamine
• Dermotropic  affect tissue of heart
DIGIOXIN • 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
DOBUTAMINE • Used in treatment of cardiogenic shock and severe heart failure. • Beta 1 adrenergic agent Dobutamine Chonotropic Effect Increase heart beat forcibly Inscrease in CO maintaining blood flow to vital organs
DOPAMINE • Released from brain • dopamine as neurotransmitter—a chemical released by neurons (nerve cells) to send signals to other nerve cells.
DOPAMINE • Acts differently in different dose ( LOW, MEDIUM and HIGH Dose ) • Acts on dopamine, alpha and beta receptors • Low dose : • Used for treating hypovolemic and cardiogenic shock stimulate beta 1 receptor in kidney Cause vasodilation Inscrease blood flow to kidney
• Modrate dose • Stimulates beta 1 receptor cause increase rate with force inscrease CO • High Dose • Stimulates alpha recetor vasoconstriction increase BP
FLUID REPLACEMENT • Used to replace blood or other fluids during hypovolemic shock • Generally replacement done are • Blood, • colloids, • crystalloids
BLOOD • Whole Blood • Blood from standard donation • indicated for acute and massive blood loss • Will replace plasma volume • Supply RBC’s
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
CRYSTALLOIDS • IV solutions that contain electrolyes that is same as contained in plasma • Like colloids leave blood and enter into cell • Used for • replacing fluid lost • Inscrese urine output • Include • NS, RL, Hypertonic Saline • 5% dextrose
THANKS
Drugs for treating shock