Hypotension Flashcards
shock, postural hypotension (14 cards)
How is postural hypotension defined
a fall in systolic bp of at least 20 mmHg (> 30 mmHg in patients with HTN) and/or a fall in diastolic bp of at least 10 mmHg within 3 minutes of standing
Give 4 causes of postural hypotension
- hypovolaemia
- autonomic dysfunction: diabetes, Parkinson’s
- drugs
- alcohol
Name 4 drugs that cause postural hypotension
- L-dopa
- alpha blockers
- TCAs
*antihypertensives - diuretics
Give 4 RFs for postural hypotension
- older age
- volume depletion/anaemia
- autonomic neuropathy
- hypertension
How is postural hypotension managed
- eliminate aggravating factors
- lifestyle changes
- midodrine or droxidopa
What is shock?
a pathophysiological state that may be due to:
* insufficient tissue perfusion
* increased oxygen demand
* inadequate blood oxygen saturation
- leads to cellular and organ dysfunction.
What are the 5 main types of shock?
- Septic
- Haemorrhagic
- Neurogenic
- Cardiogenic
- Anaphylactic
What is sepsis
life-threatening organ dysfunction caused by a dysregulated host response to infection
What is septic shock
occurs when the arterial bp drops despite adequate fluid resuscitation, resulting in organ hypoperfusion.
What are the diagnostic criteria for septic shock?
- Mean arterial pressure (MAP) < 65 mmHg despite fluid resuscitation
- Serum lactate > 2 mmol/L
What causes serum lactate levels to rise in septic shock?
Anaerobic respiration due to poor tissue perfusion.
What is the initial treatment for septic shock?
Aggressive IV fluid resuscitation to improve blood pressure and tissue perfusion
When should a patient with septic shock be escalated to intensive or high dependency care?
When they require vasopressors to maintain MAP despite fluid resuscitation
What are vasopressors and how do they help in septic shock?
Medications like noradrenaline that cause vasoconstriction, increasing systemic vascular resistance and MAP, thereby improving tissue perfusion.
