Pharmacotherapy of shock
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The document discusses the pharmacotherapy of shock, including the pathophysiology, types, and management of shock with a focus on drug therapy. It describes the determinants and hemodynamic states of shock, and covers the main classes of shock including hypovolemic, distributive, cardiogenic, and obstructive shock. It also discusses management of shock through restoration of tissue perfusion and oxygenation. Inotropic agents and vasodilators/vasoconstrictors are reviewed as important pharmacologic options to enhance cardiac output or systemic vascular resistance in shock states.
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Pharmacotherapy of shock
This document provides information on the pharmacotherapy of shock. It defines shock and describes the different types including hypovolemic, cardiogenic, obstructive, distributive, and septic shock. It discusses the mechanisms and clinical presentations of hypovolemic and septic shock in detail. It outlines the management of various shock states, emphasizing fluid resuscitation and hemodynamic support, treatment of underlying causes, and use of vasopressors when needed. Case studies are provided to demonstrate application of the management principles.
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Class drug therapy of shock
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Hemodynamic derangements and shock can be classified in several ways. Shock is defined as inadequate tissue perfusion resulting in cellular oxygen debt. There are four main types of shock based on hemodynamic parameters: hemorrhagic, cardiogenic, distributive, and obstructive. Etiologically, shock can be caused by hemorrhage, cardiac issues like myocardial infarction, sepsis/systemic inflammatory response syndrome, or anaphylaxis due to peripheral vasodilation. If not treated, shock can progress to organ dysfunction and failure due to hypoxic injury. Management involves identifying the cause, restoring intravascular volume and blood pressure, and treating the underlying condition.
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This document provides an overview of vasopressors and inotropes used in critical care to treat shock. It discusses the different types of shock and principles of resuscitation including fluid administration and optimization of oxygen delivery and consumption. It also reviews the mechanisms of action, indications, and side effects of commonly used vasopressors and inotropes like dopamine, dobutamine, milrinone, levophed, phenylephrine, epinephrine, and vasopressin. Case studies are presented to demonstrate how these agents may be applied based on a patient's hemodynamic status.
Hyovolemic shock
Hypovolemic shock is a life-threatening emergency in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.
Hypovolemic shock is a dangerous condition that happens when suddenly lose a lot of blood or fluids from body. This drops blood volume, the amount of blood circulating in body. That’s why it’s also known as low-volume shock.
3,4- Anti-arrhythmic drugs.pptx
This document discusses antiarrhythmic drugs, which are used to treat abnormal heart rhythms (arrhythmias). It begins by defining arrhythmias and describing the cardiac conduction system. It then classifies antiarrhythmic drugs into four main categories (Classes I to IV) based on their mechanisms of action and effects on heart cells. For each class, examples of drugs are provided along with their indications, mechanisms, side effects and other important details. The document emphasizes the importance of understanding antiarrhythmic pharmacology given the risk of side effects like worsening arrhythmias if these drugs are not used appropriately.
Shock Comprehensive
This document provides an overview of neonatal shock and hypotension. It defines shock, discusses the pathophysiology including factors that influence cardiac output and blood flow to tissues. It describes the stages of shock, risk factors, clinical manifestations, evaluation and treatment including volume expanders and vasoactive drugs. Specific types of shock like hypovolemic, cardiogenic, distributive and their treatments are explained. Intractable shock and further care are also summarized.
Pathophysiology, Pharmacology and Treatment of Shock
This document provides an overview of shock, including its pathophysiology and classification. It discusses the main types of shock: hypovolemic, cardiogenic, distributive, and obstructive. For each type, it describes the causes, characteristics, and treatment approaches. It also covers fluid resuscitation, vasopressors, inotropic drugs, and mechanical ventilation as general treatment strategies for shock.
Pharmacolgy of heart failuer 19-2-2024 .ppt
This document discusses drugs used to treat heart failure. It explains that heart failure occurs when the heart cannot provide enough oxygen to the body. The most common cause in the US is coronary artery disease. Drugs that target processes outside the heart, like the kidneys, have been shown to be effective long-term treatments. Specifically, ACE inhibitors, beta-blockers, and spironolactone have been proven to prolong life for those with chronic heart failure. Positive inotropic drugs can help with acute heart failure but only reduce symptoms in chronic cases.
Reaction Paper On Ramipril
Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. Essential hypertension is the most common type of high blood pressure, accounting for 90-95% of cases, where the cause is unknown. Left untreated, hypertension can increase the risks of heart disease and stroke, two of the leading causes of death globally.
Obstetrical Emergency in details this plan of clinical teaching. word file
This document outlines an obstetrical emergency seminar on shock, vasa previa, and uterine inversion. It defines each condition and discusses causes, types, diagnosis, symptoms, and management. Shock is summarized as a condition resulting from circulatory system inability to provide tissues with oxygen and nutrients. Types of shock include hemorrhagic, neurogenic, endotoxic, and anaphylactic. Vasa previa is defined as babies' blood vessels crossing near the uterus' internal opening, putting them at risk of rupture during membrane rupture. Risk factors include velamentous cord insertion and IVF pregnancy. Uterine inversion occurs when the uterus turns inside out, and can be acute or chronic with causes including uterine atony
BP, the Kidneys and Diuretics as Anti-hypertensive Agents (Rapid Review)
BP, the Kidneys and Diuretics as Anti-hypertensive Agents (Rapid Review)Imhotep Virtual Medical School
This document provides a rapid Socratic review of blood pressure, the kidneys, and diuretics used to treat hypertension. It begins by defining normal and abnormal blood pressure readings according to JNC 7 guidelines. It then reviews the renal mechanisms that regulate blood pressure and the roles of the renin-angiotensin-aldosterone system. Several questions are then asked and answered about the mechanisms and sites of action of various diuretic drug classes - including thiazide, loop, and potassium-sparing diuretics - that are used to treat hypertension by reducing blood volume and sodium retention. Potential adverse effects of different diuretics are also discussed.Pharmacology from bule hora University in Ethiopia
Pharmacology from bule hora University in Ethiopia
Scarecrow Nti
The document summarizes the management of a traumatic brain injury (TBI) case involving a teenage male patient. Key aspects included initial presentation with subdural hematoma and injuries, multimodal monitoring including cerebral oxygenation and ICP, fluid management over multiple days, and eventual recovery with discharge to home after 3 weeks with significant improvement. Lessons learned emphasized the fluid needs of TBI patients beyond just the brain injury, importance of cerebral oxygenation monitoring, and avoiding premature discontinuation of analgesics or anxiolytics.
Shock
The document discusses shock and its stages, defining it as a physiologic state characterized by reduced tissue perfusion due to issues like blood loss or decreased cardiac contractility. It covers the stages of shock and types like hypovolemic, cardiogenic, and distributive shock, explaining their pathophysiology, assessment, and management with a focus on hypovolemic and cardiogenic shock.
2012 critical care updates participation slides
This document provides information about a self-evaluation process copyrighted by the American Board of Internal Medicine. It contains a warning that copying or reproducing the work is illegal without permission. It also notes a learning session to be held on July 16th, 2012 at Scott & White where two doctors will be presenting.
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Pathophysiology, Pharmacology and Treatment of Shock
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Obstetrical Emergency in details this plan of clinical teaching. word file
Obstetrical Emergency in details this plan of clinical teaching. word file
BP, the Kidneys and Diuretics as Anti-hypertensive Agents (Rapid Review)
BP, the Kidneys and Diuretics as Anti-hypertensive Agents (Rapid Review)
Pharmacology from bule hora University in Ethiopia
Pharmacology from bule hora University in Ethiopia
More from raj kumar
The umbilical cord
The umbilical cord connects the fetus to the placenta and measures approximately 50 cm in length and 2 cm in diameter at term. It contains one vein that carries oxygenated blood to the fetus and two arteries that carry deoxygenated blood away. The cord inserts into the placenta near its center in most cases. Abnormalities can include abnormal insertion points, short or long length, knots, torsion, hematoma, or having a single umbilical artery instead of two.
The placenta
The placenta develops from fetal and maternal tissues to function as the respiratory, nutritive, excretory, barrier and endocrine organ of pregnancy. It transfers oxygen, nutrients and waste between the mother and fetus. The placenta can develop abnormalities in its shape, size, position or adhesion to the uterine wall which may cause complications like preterm birth or hemorrhage. Placental lesions like infarcts may also occur due to conditions like hypertension.
The foetal membranes
The document discusses the fetal membranes, which include the chorion and amnion. The chorion is the outer membrane that is attached to the placenta and uterine wall. The amnion lines the chorion and encloses the fetus and amniotic fluid. The amniotic fluid provides protection and nutrition for the fetus, and aids in temperature regulation and movement. It is composed primarily of water, carbohydrates, proteins and minerals. The amniotic fluid circulates continuously, with production from the fetal membranes, fetal urine and transudation from maternal and fetal blood.
Physiology of reproduction
The document summarizes the key stages in human reproduction from fertilization through early pregnancy development. It describes how sperm mature and are capacitated in the female reproductive tract. Upon ovulation, sperm meet and fertilize the ovum in the fallopian tubes. The zygote then undergoes cell division and develops into a blastocyst that implants in the uterus. The trophoblast cells of the blastocyst invade the uterine lining and develop into a placenta to exchange nutrients and waste with the mother's blood. Major developmental milestones in early pregnancy include chorion, amnion and decidua formation.
Minor complaints during pregnancy
The document discusses several minor complaints that may occur during pregnancy, including gingivitis, ptyalism, heartburn, constipation, hemorrhoids, varicosities, dyspnea, urinary symptoms, leucorrhea, leg cramps, paraethesia, and backache. For each complaint, the causes and recommended treatments are provided.
Diagnosis of pregnancy
This document discusses the diagnosis of pregnancy over three trimesters. In the first trimester, common symptoms include missed periods, morning sickness, frequent urination, and breast changes. Signs include enlarged, soft breasts and uterus, and a softer, purplish cervix. Pregnancy tests detect human chorionic gonadotropin in urine or blood. Ultrasounds can visualize the gestational sac after 4-5 weeks. In the second trimester, symptoms decrease while the abdomen enlarges and fetal movement is felt. Signs include skin changes and palpable fetal parts. The third trimester confirms pregnancy through palpation of fetal parts and auscultation of the fetal heart.
Antenatal care
Antenatal care involves regular checkups during pregnancy to monitor the health of the mother and baby. Checkups include exams, tests, and education on nutrition, exercise, hygiene, warning signs and avoiding risks. The goals are to prevent or treat complications, detect issues, and ensure healthy development. Women receive more frequent exams as their due date approaches, and are instructed on a nutritious diet, moderate exercise, adequate rest, hygienic practices, and when to seek medical help if problems arise.
Postpartum mood disorders
The document discusses postpartum mood disorders, including prevalence, risk factors, screening tools, diagnosis, and treatment options. It notes that postpartum mood disorders range from mild and temporary postpartum blues to more severe postpartum depression and postpartum psychosis. Screening tools like the Edinburgh Postnatal Depression Scale can help identify at-risk women. Treatment involves psychosocial therapies and may include antidepressant medication depending on severity. A multidisciplinary approach is important to address biological, psychological and social factors.
Normal and abnormal puerperium
Uterine fibroids are benign smooth muscle tumors that develop in the uterus. They are the most common solid pelvic tumors, affecting 20-25% of women during their reproductive years. Fibroids can vary in size and location, and may cause heavy menstrual bleeding, pelvic pressure or pain. Treatment options include observation, medical therapy to reduce estrogen levels, or surgical removal of fibroids.
Version
Version refers to changing the fetal lie or position in the uterus. There are three main types: external cephalic version, internal podalic version, and bipolar podalic version. External cephalic version involves manipulating the fetus externally to convert a breech presentation to head-first. Internal podalic version is performed under anesthesia when the cervix is fully dilated to grasp the fetus's feet and convert a transverse lie to breech. Bipolar podalic version uses both internal and external manipulation through a partially dilated cervix for special circumstances. Complications can include fetal distress, premature separation of the placenta, and maternal hemorrhage.
Vacuum extraction (ventouse)
Vacuum extraction is a method to assist in childbirth using suction from a cup placed on the baby's head to help with traction during contractions. There are different types of cups including metal, soft, and bird's cups. Vacuum extraction is indicated when forceps cannot be used and has advantages over forceps like less need for anesthesia and less compression force applied. Complications can include maternal lacerations and cervical injuries or fetal issues like cephalhematomas and scalp lacerations.
Symphysiotomy
Symphysiotomy is a surgical procedure that divides the symphysis pubis bone to widen the pelvis during childbirth. It is indicated when cephalopelvic disproportion makes vaginal delivery difficult or dangerous but cesarean section is not available or advised. The procedure involves making a small incision above the pubic bone and gradually separating the joint using a scalpel. Complications can include bleeding, injury to nearby organs, infection, and long-term issues like incontinence or an unstable pelvis.
Forceps delivery
This document discusses obstetric forceps, which are metal instruments used to extract a baby's head during delivery. It describes different types of forceps and their proper application techniques. Forceps are indicated for prolonged second stage of labor, maternal distress, or fetal distress. Correct application involves inserting one blade along each side of the baby's head. Potential complications include laceration, hemorrhage, nerve injury, or problems for the baby such as skull fractures. Failure to deliver with forceps may require removal and assessment to determine if cesarean section is needed.
Episiotomy
This document discusses episiotomy, which is an incision made in the perineum during childbirth to widen the vaginal opening. It can help prevent tearing and complications. The two main types are median and mediolateral episiotomies. Median episiotomies involve a midline incision while mediolateral incisions extend laterally towards the ischial tuberosity. Episiotomies are usually performed when the vaginal opening is distended during crowning to prevent stretching injuries. They are sutured closed after delivery.
Caesarean section
The document discusses Caesarean section, including indications, types, procedure, complications, and mode of delivery in subsequent pregnancies. A Caesarean section is a surgical procedure to deliver one or more babies through incisions in the abdomen and uterus. The rate of Caesarean sections has increased from 5% in 1970 to 25% in 1990 due to factors such as abandoning difficult procedures in favor of C-sections and increased use for breech births. Complications can include hemorrhage, infections, and injuries to the mother or baby.
Normal labour
Normal labour involves the spontaneous expulsion of a single, mature fetus through the birth canal within 3-18 hours without complications. It occurs when hormonal and mechanical factors cause the cervix to efface and dilate in stages from 3cm to full 10cm dilation. Labour proceeds through four stages: 1) cervical dilation, 2) expulsion of the fetus, 3) expulsion of the placenta, and 4) recovery. The fetus descends through the birth canal with increased flexion to facilitate delivery of the head.
Anatomy of the foetal skull
The fetal skull consists of three parts: the vault, face, and base. The vault is made up of the frontal, parietal, and occipital bones which are separated by sutures. The face extends from the chin to the nose. Fontanelles are soft spots located where sutures meet which are important for assessing fetal position and flexion. The skull has various longitudinal and transverse diameters used to determine which will engage and pass through the birth canal during delivery.
Anatomy of the female pelvis
The female pelvis is divided into the false pelvis and true pelvis. The true pelvis is further divided into the pelvic inlet, cavity, and outlet. The document describes the boundaries and diameters of each region including the anatomical transverse diameter of 13cm at the inlet. It also discusses the pelvic planes and axes, and the Caldwell-Moloy classification of pelvic types including the gynaecoid, anthropoid, android, and platypelloid pelvis.
Active management of normal labour
This document outlines the active management of normal labour in 4 stages: antenatal preparation, first stage (history, exam, procedures), second stage (delivery of baby), third stage (delivery of placenta), and fourth stage (postpartum care of mother and baby). The goal is a healthy delivery with minimal effects. Key procedures include monitoring contractions/fetal heart with a partogram, positioning, nutrition, analgesia, perineal support, and immediate newborn care.
Thyrotoxicosis in pregnancy
Thyrotoxicosis in pregnancy can cause complications like abortion and preterm labour. Clinical features include weight loss, heat intolerance, tremors, and fast heart rate. It is treated with antithyroid drugs like propylthiouracil or carbimazole. Epilepsy in pregnancy commonly presents as grand mal seizures, which are treated with phenobarbitone or phenytoin along with folic acid. Rhesus isoimmunization occurs when an Rh-negative mother develops antibodies against Rh-positive blood from her baby. It can be prevented by giving the mother anti-D immunoglobulin after delivery or pregnancy events involving blood transfer from baby to mother. Affected babies may require monitoring, phot
More from raj kumar (20)
Pharmacotherapy of shock
- 1. Pharmacotherapy of Shock www.freelivedoctor.com
- 13. Question 04/20/10 Which one of the folowing is the most common cause of severe Lactic acidosis (blood lactate concentration >5 mmol/L)? a. Ethanol intoxication b. Severe liver disease c. Circulatory shock d. Ischemic bowel e. Acute asthma www.freelivedoctor.com
- 15. Pulmonary Artery Catheter Waveforms 04/20/10 Right Atrium Right Ventricle Pulmonary Artery PCWP www.freelivedoctor.com
- 16. Hemodynamic Characteristics in Different Types of Shock 04/20/10 / www.freelivedoctor.com Type Preload CO PVR SVR Hemmorrhagic Anaphylactic Cardiogenic Septic (Hyperdynamic) Septic (Hypodynamic)
- 17. Question 04/20/10 The wavefrom shown in this figure was observed while attempting to advance a pulmonary arterial catheter, with the Balloon inflated, from the proximal pulmonatry artery to a “ wedged” position. Which one of the following bv Which one of the following best explains the terminal portion of the depicted waveform? a. Pulmonary hypertension b. Mitral regurgitation c. Severe left ventricular dysfunction d. Obstruction of the catheter tip e. Pericardial tamponade www.freelivedoctor.com
- 19. Effects of Inotropic Agents and Vasodilators 04/20/10 Drug Receptor CO SVR Dose Range 0 - ( g/kg/min) 1 www.freelivedoctor.com Epinephrine 0.02 – 0.5 Norepinephrine 0 - 0.05 – 0.5 Dopamine DR 2 -12 Dobutamine 2 - 12 Dopexamine DR 0 - 0.9 - 5 Vasopressin Angiotensin III 5 - 20 Amrinone PDI 5 -10
- 20. Effects of Inotropic Agents and Vasodilators 04/20/10 2 Drug CO SVR Dose Range ( g/kg/min) www.freelivedoctor.com Nifedipine 0 - 0.5 - 10 Nitroglycerin 0 - 3 - 5 Nitroprusside 0 - 0.5 - 5 Prostacyclin 10 - 40