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Types of Shock
Drugs and Others
Early (hyperdynamic) and Late (hypodynamic Se
100

Acid base and oxygenation state seen in early/warm hyperdynamic, septic shock? Some more pearls to consider with early/warm hyperdynamic septic shock are... Increased PT, and aPTT increased, Decreased platelets, Increased WBC count, Increased Glucose

What is respiratory alkalosis with hypoxemia?

100
Measured by continuously fiberoptic PA catheter. Measures the oxgen staturation at the distal end of the catheter. Gobal measure of oxygen consumption and delivery; normal value is 60-80%. Low values result from high oxygen demands (or consumption) or reduced delivery of oxgyen. High values result from higher oxgyen delvery, or when tissues are unable to use the oxygen (e.g., septic shock)!!!!!!
What is mixed venous oxgyen saturation (SvO2) monitoring?
100
Bradycardia, decreased SVR, decreased SvO2
What is Neurogenic shock?
100
Norepinephrine (Levophed) - (alpha receptor stimulation), Phenylephrine (Neosynephrine) - (alpha receptor stimulation), Dose specific Dopamine (Intropin) at >10mcg/kg/min (alpha receptor stimulation), Vasopressin
What are drugs used to increase afterload in shock?
100
Tachycardia, Pulses weak and thready, Hypotension, Narrow pulse pressure, Skin cool, pale, Bradypnea or tachypnea, Decreased level of consciousness (lethargy or coma), Anuria
What are clinical manifestations of late/cold hypodynamic septic shock?
200
A marker of anaerobic metabolism (elevated levels indicate significant hypoperfusion.
What is serum lactate level?
200
Condition occuring in the compensatory stage of shock associated with hyperventilation.
What is respiratory alkalosis?
200
Increased RAP, PAP, PAOP, increased SVR, increased SvO2. I like my milrinone and IABP.
What is Cardiogenic shock?
200
Sodium Nitroprusside (Nipride), Nitroglycerin (Tridil)
What are some drugs to decrease afterload in shock?
200
Decreased CO/CI , RAP/PAP/PAOP variable, SVR variable, Decreased SvO2 ,
What are hemodynamic parameters of late/cold hypodynamic septic shock?
300
As a response of decreased renal perfusion, the juxtaglomerular apparatus releases this and reacts with angiotensin I to produce angiotensin II. Also activates the release of ADH and aldosterone.
What is renin?
300
A complication associated with hypoperfusion and pulmonary hypotension.
What is ARDS?
300
Tachycardia, decreased SVR, increased SvO2
What is hyperdynamic (warm) septic shock?
300
Shirley's favoriate drug helps to increase contractility and decrease afterload. A good drug for cardiogenic shock with poor contractility. Be sure to watch for dysrhythmias and maybe decrease in platelets (not seen as much as in some of the other phosphodiasterase drugs.
What is Milrinone (Primacor)?
300
ABGs: metabolic acidosis with hypoxemia, Increased PT and aPTT, Decreased platelets , Decreased WBC count , Decreased glucose, Increased BUN, creatinine , Increased serum arterial lactate , Increased amylase, lipase , Increased AST, ALT, LDH
What are diagnostic findings of late/cold hypodynamic septic shock?
400
Prolonged inadequate tissue perfusion contributes to this problem.
What is MODS?
400
hyperglycemia, tachycardiac and hyperventilation.
What are hormonal, neural, and chemical signs seen during the compensatory phase of shock?
400
Decreased RAP, PAP, PAOP, increased SVR, decreased SvO2. Causes may be relative or absolute. HUM...
What is hypovolemic shock?
400
Lactated Ringers and Normal Saline .9%
What are crystolloids?
400
Tachycardia, Pulses bounding, Blood pressure: normal or low, Wide pulse pressure, Skin warm, flushed, Hyperpnea, Change in mental status (e.g., irritability and confusion), Oliguria, Hyperthermia
What are clinical findings in early/warm hyperdynamic septic shock?
500
Vasodilation occurring in distributive shock results in
What is decreased venous return (preload)?
500
The first system to be affected by changes in celluar perfusion
What is central nervous system?
500

Tachycardia, decreased SVR, decreased SvO2. Bee sting, wrong med. Where's my epi pen!

What is Anaphylactic shock?

500
Arterial vasodilation, Alpha-blockers, ACE inhibitors, Angiotensin II receptor blockers (ARB’s), Beta blockers – cardioselective and nonselelctive (decrease release of renin), Calcium channel blockers, Hydralazine (Apresoline)
What are examples of drugs used to decease afterload?
500
Increased CO/CI, Decreased RAP/PAP/PAOP , Decreased SVR, Increased SvO2
What are hemodynamic parameters of early/warm hyperdynamic shock?