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The Surviving Sepsis Campaign guidelines recommend the very early management of the sepsis focusing on the hour-1 bundle. This includes use of Vasopressin 0.03 units/minute as add-on to norepinephrine (NE) with intent of either raising the mean arterial pressure or decreasing the norepinephrine dosage (i.e. de-catecholaminization). [13]
Desmopressin, sold under the trade name DDAVP among others, is a medication used to treat diabetes insipidus, bedwetting, hemophilia A, von Willebrand disease, and high blood urea levels. [1] In hemophilia A and von Willebrand disease, it should only be used for mild to moderate cases. [ 1 ]
Prazosin is active after taken by mouth and has a minimal effect on cardiac function due to its α 1-adrenergic receptor selectivity.When prazosin is started, however, heart rate and contractility can increase in order to maintain the pre-treatment blood pressures because the body has reached homeostasis at its abnormally high blood pressure.
The "vaptan" drugs act by directly blocking the action of vasopressin at its receptors (V 1A, V 1B and V 2).These receptors have a variety of functions, with the V 1A and V 2 receptors are expressed peripherally and involved in the modulation of blood pressure and kidney function respectively, while the V 1A and V 1B receptors are expressed in the central nervous system.
Norepinephrine, also known as noradrenaline and sold under the brand name Levophed among others, is a medication used to treat people with very low blood pressure. [2] It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids. [3]
As the evidence and consensus for use of the drug increases and strengthens, its class of indication is improved. [6] Preferred drugs (and other treatments) are also referred to a "first line" or "primary" while others are called "second line", "third line" etc. [7] [8] A drug may be indicated as an "adjunct" or "adjuvant", added to a first ...
Terlipressin is indicated to improve kidney function in adults with hepatorenal syndrome with rapid reduction in kidney function. [2]Indications for use include norepinephrine-resistant septic shock [7] although, 2021 Surviving Sepsis Guidelines recommend against its use for adults with septic shock [8] and hepatorenal syndrome. [9]
A commercially prepared pre-filled syringe of metaraminol for bolus use during anaesthesia, made up as 0.5 mg/mL (2.5 mg in 5 mL). Metaraminol is given intravenously as either a bolus (often 0.5–1 mg doses) or as an infusion, usually via peripheral intravenous access.