Vasopressor resident survival guide: Difference between revisions
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{{Family tree | | | | | B01 | | B02 | | B03 | | B04 | | B05 | |B01='''Norepinephrine''' |B02='''Dopamine''' |B03='''Vasopressin''' |B04='''Phenylephrine'''|B05='''Dobutamine''' }} | {{Family tree | | | | | B01 | | B02 | | B03 | | B04 | | B05 | |B01='''Norepinephrine''' |B02='''Dopamine''' |B03='''Vasopressin''' |B04='''Phenylephrine'''|B05='''Dobutamine''' }} | ||
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | {{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | ||
{{Family tree | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | |C01= '''Mechanism''' |C02= *Mainly '''α1'''agonist (Vasoconstrictive) <br> *β1 (↑contractility) |C03= *Mainly '''β1'''agonist (↑contractility) <br> *α1 agonist(Vasoconstrictive)|C04= *'''V<sub></sub>1''' receptor of GIT vasculatures <br> *Antidiuretic effects |C05= *'''Pure α1'''agonist(Vasoconstrictive) <br> *No β1 |C06= *Mainly '''β1''' agonist (↑contractility) <br> *β2 arterial smooth muscle (Hypotensive) }} | {{Family tree | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | |C01= '''Mechanism''' |C02= *Mainly '''α1''' agonist (Vasoconstrictive) <br> *β1 agonist (↑contractility) |C03= *Mainly '''β1''' agonist (↑contractility) <br> *α1 agonist(Vasoconstrictive)|C04= *'''V<sub></sub>1''' receptor of GIT vasculatures <br> *Antidiuretic effects |C05= *'''Pure α1''' agonist(Vasoconstrictive) <br> *No β1 |C06= *Mainly '''β1''' agonist (↑contractility) <br> *β2 arterial smooth muscle (Hypotensive) }} | ||
{{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | {{Family tree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | |}} | ||
{{Family tree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | |D01= '''Indication''' |D02= *1st line '''Septic shock''' <br>*1st line '''Cardiogenic shock''' <br>*Undifferentiated shock |D03= 2nd line septic shock |D04= 2nd line septic shock |D05= 1st line '''Neurogenic shock''' <BR> 3rd-4th line septic shock |D06= *1st line '''cardiogenic shock''' <BR>* low output septic shock }} | {{Family tree | D01 | | D02 | | D03 | | D04 | | D05 | | D06 | |D01= '''Indication''' |D02= *1st line '''Septic shock''' <br>*1st line '''Cardiogenic shock''' <br>*Undifferentiated shock |D03= 2nd line septic shock |D04= 2nd line septic shock |D05= 1st line '''Neurogenic shock''' <BR> 3rd-4th line septic shock |D06= *1st line '''cardiogenic shock''' <BR>* low output septic shock }} | ||
Revision as of 15:04, 6 December 2013
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Diagnosis |
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Treatment |
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Vasopressor resident survival guide On the Web |
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Risk calculators and risk factors for Vasopressor resident survival guide |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]
Definition
Causes
Life Threatening Causes
Common Causes
Prognosis
Management
| Vasopressors | |||||||||||||||||||||||||||||||||||||||||||||||||
| Norepinephrine | Dopamine | Vasopressin | Phenylephrine | Dobutamine | |||||||||||||||||||||||||||||||||||||||||||||
| Mechanism | *Mainly α1 agonist (Vasoconstrictive) *β1 agonist (↑contractility) | *Mainly β1 agonist (↑contractility) *α1 agonist(Vasoconstrictive) | *V1 receptor of GIT vasculatures *Antidiuretic effects | *Pure α1 agonist(Vasoconstrictive) *No β1 | *Mainly β1 agonist (↑contractility) *β2 arterial smooth muscle (Hypotensive) | ||||||||||||||||||||||||||||||||||||||||||||
| Indication | *1st line Septic shock *1st line Cardiogenic shock *Undifferentiated shock | 2nd line septic shock | 2nd line septic shock | 1st line Neurogenic shock 3rd-4th line septic shock | *1st line cardiogenic shock * low output septic shock | ||||||||||||||||||||||||||||||||||||||||||||
| Dose | 1-30 mcg/kg/min | 1-20 mcg/min | 0.03 unit/min | 20-300 mcg/kg/min | 2.5-20 mcg/kg/min | ||||||||||||||||||||||||||||||||||||||||||||
| Complications | Less tachyarrhythmia (less β1) than Dopamine | Arrhythmia (more β1) | *Coronary spasm *Splanchnic vasoconstriction | Reflex bradycardia No worsening of Tachycardia (only α1) | Hypotension (β2) | ||||||||||||||||||||||||||||||||||||||||||||
| Cautions | Arrhythmia | *Not in cardiogenic shock *Arrhythmia *cardiotoxicity with ischemia | *Ischemic heart if (Troponin > 10) *Gut ischemia | If hypotension, add α1 agonist | |||||||||||||||||||||||||||||||||||||||||||||
Do's
- Assess the cause of shock
- Always volume fluid resuscitation first
- Norepinephrine in undifferentiated shock.