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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
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 Classification and Differential Diagnosis
SHOCK
 • MAP <65, SBP <90, drop in SBP > 40
 •
Shock Classification ... Differential Diagnosis SHOCK ... Failure, Toxins/Medications ... #Classification ... Diagnosis #Types #criticalcare
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
Shock Classification Types - Pathophysiology Comparison

Obstructive Shock:
 • Obstructive shock is characterized by a blockage in
Shock Classification ... Pathophysiology Comparison ... in blood flow caused ... Depends on the cause ... #Comparison #criticalcare
Pressors and Inotropes

Norepinephrine
 • alpha1 > beta 1
 • Increase SVR > Inotropy
Vasopressin
 • V1
 •
1 • Increase SVR ... 1 • Increase SVR ... Pressors #Inotropes #criticalcare ... #pharmacology #comparison ... #shock #management
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
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
Shock - Differential ... findings based on cause ... uw_IMresidency #Shock ... Diagnosis #table #comparison ... #criticalcare
Shock - Diagnosis and Management Summary
 • Hypotension: SBP<90, SBP drop >40, MAP<65 (Normotension, HTN possible
and Management ... Prepare • Full Set ... Neurogenic >> Vasopressors ... #Diagnosis #Management ... #Summary #criticalcare