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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 |
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