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Vasopressors Demystified

Shock comes in many flavors and so do vasopressors. Here’s a OnePager summarizing my approach
Vasopressors Demystified ... Shock comes ... #Basics #CriticalCare ... #Management #Pharmacology ... #Comparison #Inotropes
Common Vasopressors and Inotropes
Norepinephrine (NE)
 - Indication: Distributive shock (1st line for septic shock), Cardiogenic shock
Common Vasopressors ... Bradyarrhythmias, Some cases ... Cardiac ischemia #Vasopressors ... #Inotropes #comparison ... #pharmacology #criticalcare
Vasopressors and Inotropes - Pharmacology Summary
Vasopressors
Phenylephrine (alpha-1)
 • Increases BP, SVR
 • Risk of reflex bradycardia
first agent in shock ... • Higher doses cause ... line in septic shock ... Pharmacology #Summary #management ... #medications
Vasopressors and Inotropes
 • Norepinephrine - Levophed - "Levo" - Generally thought of as the first
Vasopressors and ... #Inotropes #management ... #criticalcare # ... summary #comparison ... #pharmacology #indications
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
Shock - Differential ... High CO / Low SVR ... Failure, Toxins/Medications ... Differential #Diagnosis #criticalcare ... algorithm #treatment #management
Sepsis - Diagnosis and Management
Life-threatening organ dysfunction caused by a dysregulated host response to infection
SEPTIC SHOCK
organ dysfunction caused ... infection SEPTIC SHOCK ... Patients w/ septic shock ... WBC > 12 K or < ... #QSOFA #SIRS #criticalcare
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Etiology: • Medications ... Peak T, flat P, ST ... only if no clear cause ... STOP offending medications ... concurrent need for vasopressor
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
irrigation • Management ... Inhibitors of Na+K+ ... Kidney stones caused ... • Hypovolemic shock ... #Pharmacology #Medications