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Drugs for shock
Pharm exam 3
Question | Answer |
---|---|
define shock | decreased blood supply to tissue |
clinical manifestations of shock | decreased BP, increase HR, increased RR, cool extremities, lowered urinary output, may or may not be conscious |
6 types of shock | hypovolemic, cardiogenic, distributive, anaphylactic, neurogenic, septic |
define hypovolemic shock | blood loss or fluid shifts |
define cardiogenic shock | pump failure |
define disributive shock | vasodilatation |
define anaphylactic shock | allergic response |
define neurogenic shock | lack of SNS stimulation |
define septic shock | infection (bacteria/fungi) |
4 nursing considerations for patients with shock | assess condition, treat cause, positioning, medicaitons |
example of treating cause of shock (ie: blood loss) | stop hemorrhage, start IV, push fluids, give blood |
example of treating cause of shock (ie: septic) | give antibiotics |
positioning to help with shock | feet up, except HOB elevated with cardiogenic shock |
What positioning is used in cardiogenic shock? | HOB elevated |
general medications used in shock | adrenergic agents (vasopressors); always given on a pump, close monitoring of patient |
How are medicaitons given for shock? | always on a pump |
prototype medication for shock | epinephrine (adrenalin) |
what type of medication is epinephrine (Adrenalin)? | potent inotropic = cardiac simulation |
Therapeutic use for epinephrine (adrenalin) | usually for severe anaphylactic shock, allergy (not cardiac shock or cardiac dysrhythmias) |
Kinetics of epinephrine (adrenalin) | IV, SC (Epi-pen), inhalation |
dynamics of epinephrine (adrenalin): onset | immediate, peak 2-5 (minutes), duration 5-10 (minutes) |
What type of medication is norephinephrine (Levophed)? | potent vasoconstrictor |
Kinetics of norephinephrine (Levophed) | IV titrated according to BP |
Norephinephrine (Levophed) is drug of choice for what? | (vasodilatation) |
When is norephinephrine (levophed) used? | after dopamine or dobutamine has been tried |
Therapeutic uses of dopamine (intropin) | hypotension, increased CO |
Advantages of using dopamine (intropin) | low dosages (less than 0.5-10 mcg/kg/min) stimulate urinary function |
Therapeutic uses of dobutamine (Dobutrex) | cardiogenic shock (acts on beta receptors) |
How does dobutamine (Dobutrex) help in cardiogenic shock? | enhance cardiac contraction, stroke volume and cardiac output |
Dobutamine (Dobutrex) is less likely to cause what? | hypertension, tachycardia |
Therapeutic use of metaraminol (Aramine) | hypotension associated with spinal anesthesia; less potent and longer duration |
How should drugs for shock be started? | on an infusion pump |
When observing for therapeutic effect of drugs for shock what are you monitoring? | BP, increase urine output, increased heart rate |
Adverse effects of medications for shock | tachycardia, dysrhythmias, hypertension, chest pain |