pharma fouda 2_p85-87.pdf

Manag gement  Hosspitalization and sitting or sem mi-sitting po osition.  High-flow oxyygen (hypo oxia causess pulmona...

Manag gement  Hosspitalization and sitting or sem mi-sitting po osition.  High-flow oxyygen (hypo oxia causess pulmona ary VC and incrreased card diac load).  Furrosemide (20-80 ( mg IV): to ↓ ve enous returrn and pulm monary con ngestion. It is the mosst importantt trea atment.  Morphine (2-4 mg IV): – T To ↓ stresss and anxieety. – V Venodilatattion → ↓ VR R → ↓ lung co ongestion. – It ↓ pulmon ch reflex → ↓ tachypnea & work nary stretc o of breathin ng.  Nitrroglycerin ne (sublingual or i.v.).  Hem modynamic c support according to systolic c BP: – Maintain systolic s BP P >100 mmmHg. – If the SBP is 40% (> 2000 ml) Coma …….. death 183  Treatment  I.v. fluids (Ringer solution is more superior to normal saline for use in massive hemorrhage).  Blood transfusion  Dopamine: to ↑ COP. █ Cardiogenic shock Causes  Acute MI  Blunt cardiac trauma  Myocardial depression due to any cause (drugs, infection, etc.). Treatment  All measures of treatment of acute MI (see before).  Dobutamine i.v.i. (usually at 5 - 20 μg/kg/min).  Lidocaine i.v. for control of ventricular arrhythmia. █ Septic shock Cause: severe infection → release of inflammatory cytokines from the inflammatory cells → venodilatation (↓ venous return) and progressive tissue hypoxia. Treatment  Antibiotics according to the type of pathogen.  Dopamine or dobutamine to ↑ COP.  Low dose steroids to minimize toxemia.  Oxygen if O2 saturation is