Drugs For Shock

Drugs for Shock Causes: trauma or bleeding,
Fluid Replacement Agents a. Hypovolemic (volume depletion) hemorrhage,

Blood and blood Products extensive burns, DHN, vomit and diarrhea.
Crystalloid Solutions : normal serum albumin b. Neurogenic shock: sudden loss of nerve impulse
(Albuminar, Albutein) communication
Vasoconstrictors/ Vasopressors: norepinephrine c. Cardiogenic shock: inadequate CO due to pump
(Levarterenol, Levophed) failure • Septic shock: presence of bacteria and
Inotropic Agents: dopamine (Dopastat, Inotropin) toxins in the blood.
Drugs for Anaphylaxis: epinephrine (Adrenalin) d. Anaphylactic shock: food or drug intake, most
severe type I allergic response
SHOCK
- wherein the vital tissues and organs are not TREATMENT:
receiving enough blood to function properly. - The goal is to maintain BLS basic life support
- Without adequate oxygen, cells cannot carry out ABC, to restore normal fluid volume and
metabolic processes composition and maintain adequate BP.
- It is considered as medical emergency and may - Connect to cardiac monitor and pulse oximeter
lead to irreversible organ damage and death - BP readings on the opposite of pulse oximeter as
- Thirst is a common complaint, skin may feel cold peripheral vasoconstriction with the inflation of BP
or clammy. cuff.
- Inability of the cardiovascular system to send - Oxygen at 15L/min via a nonrebreather mask.
sufficient blood to the vital signs: heart and brain - LOC and neurological status are monitored.
- - Quiet and warm psychological support and
Cardiovascular: BP low, CO diminished, HR may be reassurance
rapid with weak thread pulse a. Anaphylaxis
Respiratory: Breathing is rapid and shallow - to prevent or stop the hypersensitive inflammatory
Metabolism: Low temperature, thirst, acidosis, low urine response
output b. Fluid Replacement Agents
Neurologic: restless, anxious, lethargic, confusion - blood, blood products, colloids and crystalloids.
c. Treating Shock with IV infusion therapy: Nursing Considerations
- Whole blood, plasma proteins, fresh frozen - Monitor clients condition provide education as it
plasma and globulins. properly typed and cross relates to the prescribed drug treatment. Monitor
matched mental status, skin temp, ear lobes color, nail beds
- Whole blood thou being carefully screened has the and lips.
potential to transmit serious infections (hepatitis or - Assess BP and HR
HIV) - History for CV disease ( vasoconstrictors are
contraindicated in severe CV disease)
COLLOIDS (PROTEINS AND CRYSTALLOIDS) - Obtain ECG reading, monitor chest pain (reduce
- Infusions are often used when up to 1/3 of adults dosage if HR exceeds 110bp
blood volume has been lost: Hetastarch (Hespan). - monitor UO (may lead to renal perfusion)
- Massive hemorrhage, burns, acute liver failure and - Telemetry for IV therapy duration
neonatal hemolytic disease - May increase IOP, assess for narrow angle
- Common crystalloids: normal saline, lactated glaucoma
Ringer’s, Plasmalyte, and hypertonic saline (3% - Ensure IV patency and monitor site.
NaCl, 5% D5W) - Titrate IV rate if BP is elevated
- Prototype Drug: normal Serum Albumin - Severe headache (early sign of vasopressor
(Albuminar, Albutein, Buminate, Plasbumin) : Fluid overdose)
Replacement Agent/Colloid
Client Teaching:
SYMPATHOMIMETIC VASOCONSTRICTORS - Report immediately any pain on IV site
- also known as vasopressors. - Blanching or blueness of fingers
- Used to stabilize BP, discontinuation is gradual, - Chest pain or palpitations
possible for rebound hypotension and undesirable
cardiac effects INOTROPIC AGENTS
- norepinephrine (Levophed) as prototype drug - Also called cardiotonic drugs
- isoproterenol (Isuprel) - Used to increase the cardiac output
- phenylephrine (Neo-Synephrine)
- Digoxin (Lanoxin), increases myocardial - Bronchodilator albuterol (Ventolin) for SOB.
contractility and CO, thus bringing critical tissues High flow O2.
their essential oxygen. - Systemic glucocorticoids such as
- Dobutamine (Dobutrex) hydrocortisone for inflammation.
- Dopamine (Dopastat, Intropin) as prototype drug,
INOTROPIC AGENT Most common drugs causing anaphylaxis include:
- Have the potential to reverse the cardiac - antibiotics,
symptoms of shock by increasing the strength of - NSAIDs (aspirin, ibuprofen, naproxen),
myocardial contraction - ACEI,
- opioids and iodine-based contrast media for
TREATING SHOCK WITH INOTROPIC AGENTS: radiographic exams
- dobutamine – HF as a cause.
- Dopamine activates beta and alpha adrenergic Symptoms:
receptors. - histamine release
- Used to increase BP by causing peripheral - fast HR
vasoconstriction and increasing force of - decrease CO
myocardial contraction. Given only as IV infusion - Vasodilation
- Edema
ANAPHYLAXIS - itchy skin
- Fatal condition in which body defenses hyper - Bronchoconstriction
response to a foreign chemical known as antigen - dyspnea
or allergen.
- Treatment depending on the severity of the Prototype Drug: epinephrine (Adrenalin)
symptoms sympathomimetic /Anaphylaxis Drug
- Epinephrine 1:1000, given SC or IM as DOC. It
can rapidly reverse hypotension.
- May be repeated 3 times at 10-15 minute interval
- Antihistamines such as diphenhydramine
(Benadryl) maybe ordered

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Drugs for Shock Causes: trauma or bleeding,

Fluid Replacement Agents a. Hypovolemic (volume depletion) hemorrhage,

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