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The definition of refractory shock or vasodilatory shock varies. In 2018, the American College of Chest Physician stated that it is presents if there is an inadequate response to high-dose vasopressor therapy defined as ≥ 0.5 mg/kg/min norepinephrine-equivalent dose. [4]
Although both vasopressors, vasopressin and epinephrine differ in that vasopressin does not have direct effects on cardiac contractility as epinephrine does. [18] Thus, vasopressin is theorized to be of increased benefit over epinephrine in cardiac arrest due to its properties of not increasing myocardial and cerebral oxygen demands. [18]
An antihypotensive, also known as vasopressor, is an agent that raises blood pressure by constricting blood vessels, thereby increasing systemic vascular resistance. This is different from inotropes which increase the force of cardiac contraction. Some substances do both (e.g. dopamine, dobutamine).
An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics (drugs used to relieve pain). Equianalgesic charts are used for calculation of an equivalent dose (a dose which would offer an equal amount of analgesia) between different analgesics. [1]
Dosage typically includes information on the number of doses, intervals between administrations, and the overall treatment period. [3] For example, a dosage might be described as "200 mg twice daily for two weeks," where 200 mg represents the individual dose, twice daily indicates the frequency, and two weeks specifies the duration of treatment.
The NRC's definition of dose equivalent is "the product of the absorbed dose in tissue, quality factor, and all other necessary modifying factors at the location of interest." However, it is apparent from their definition of effective dose equivalent that "all other necessary modifying factors" excludes the tissue weighting factor. [17]
Shock is a medical emergency and requires urgent medical care. If shock is suspected, emergency help should be called immediately. While waiting for medical care, the individual should be, if safe, laid down (except in cases of suspected head or back injuries). The legs should be raised if possible, and the person should be kept warm.
Drug titration is the process of adjusting the dose of a medication for the maximum benefit without adverse effects. [ 1 ] When a drug has a narrow therapeutic index , titration is especially important, because the range between the dose at which a drug is effective and the dose at which side effects occur is small. [ 2 ]