MORE DRUGS FOR SHOCK

Therapeutic Aids 2





Nor-epinephrine
Norepinephrine is used mainly in patients with hypotension, persisting after volume resuscitation and other Inotrops have been tried.
The sympathetic neurotransmitter nor-epinephrine exerts both alpha and beta adrenergic effects.
The beta adrenergic effects are most prominent at lower infusion rates, leading to increases in heart rate and contractility.
With increasing doses, the alpha mediated effects become evident and are responsible for increases in systemic vascular resistance and blood pressure.

Epinephrine
Epinephrine has a broad spectrum of systemic actions.
At lower rates of infusion Beta-adrenergic responses predominate, leading to an increase in heart rate and contractility (beta 1 effect) in conjunction with peripheral vaso-dilation (beta 2 effect).
These effects result in an increase in stroke volume and cardiac output with a variable effect on blood pressure.
At a higher rate of infusion, alpha effects predominate, leading to an increase in systemic vascular resistance and blood pressure.
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