Shock neurogenic

Shock refers to conditions manifested by hemodynamic alterations (e.g., hypotension, tachycardia, low cardiac output [CO], and oliguria) caused by intravascular volume deficit (hypovolemic shock), myocardial pump failure (cardiogenic shock), or peripheral vasodilation (septic, anaphylactic, or neurogenic shock). The underlying problem in these situations is inadequate tissue perfusion resulting from circulatory failure. 

Anaphylactic, septic and neurogenic shock are the examples of distributive shock and all of which usually cause profound decrease in periperal vascular resistance. 

Neurogenic shock is generally occur in abdominal trauma, spinal anasthesia, spinal cord injury and is managed by vasopressor agents e.g. dopamine. 

Noradrenaline is used to treat shock-like conditions associated with peripheral vasodilatation, e.g. sepsis, systemic inflammatory response syndrome (SIRS), neurogenic shock. The rationale of its use in sepsis and SIRS is to counteract the vasodilatory effects of nitric oxide. Following the surgical removal of phaeochromocytoma and similar tumours, noradrenaline is often given to maintain blood pressure in the initial period. During and after cardiac surgery, it may be used to optimise haemodynamic parameters in combination with other drugs, such as phosphodi-esterase inhibitors. Dose... 

Possible applications are extensive and include the treatment of pain (e.g. in burns), inflammation, neurogenic inflammation, oedema (including cerebral oedema and angio-oedema), shock (especially septic shock, probably with B, as well as B2 antagonists), rhinitis and asthma, pancreatitis and defective ion transport, such as cholera, Crohn s disease and cystic fibrosis, and chronic inflammatory conditions such as rheumatoid and osteoarthritis. 

Godlewski G, Malinowska B, Schlicker E (2004) Presynaptic cannabinoid CBl receptors are involved in the inhibition of the neurogenic vasopressor response during septic shock in pithed rats. Br J Pharmacol 142 701-708... 

Phenox/benzamine Hypertensive episodes in phaeochromocytoma Neurogenic bladder Shock... 

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