Pharm - Shock (Objectives)
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- What is shock?
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Hypovolemia (low blood volume) that causes cardiovascular collapse
*SHOCK SYNDROME - generalized systemic response to decreased tissue perfusion - 5 Types of Shock
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1. Hypovolemic
2. Cardiogenic
3. Neurogenic
4. Anaphylactic
5. Septic - Classifying shock by cause is most useful because:
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- it helps the treatment
- give all shock patients fluids and oxygen
- depending on the cause, other treatments will vary
*Examples:
Septic shock: treat with antibiotics to get rid of the infection.
Anaphylactic shock: give anti-histamines and epinephrine. - Compensatory (early) shock sequence of events
- Initial event --> Hypovolemia --> compensatory mechanisms (fluid shift, HPA, RAA, ADH) --> maintenance of blood pressure & tissue perfusion
- Possible causes of Cold Shock (Hypovolemic & Cardiogenic shock)
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1. Loss of blood/fluid = burns, hemorrhage, DKA, vomiting, diuresis --> hypovolemia (absolute)
2. MI --> heart pump failure --> decreased circulating volume --> hypovolemia (relative) - Causes of Septic Shock & two most common sources of infection
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- severe infection from bacterial toxin
- Gram neg (pseudomonas aeruginosa)
- Gram pos (staphylococcus aureus) - toxic shock - Chemical mediators involved in septic shock
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1. PGs/Lts
2. H1
3. Complement (pokes holes in CM & causes mast cell/basophil degranulation)