Vasoconstrictor agent: Difference between revisions
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Among the choices for pressors for treating [[septic shock]], a [[randomized controlled trial]] concluded that there was no difference between the biogenic [[amine]]s [[norepinephrine]] (plus [[dobutamine]] as needed for [[cardiac output]]) versus [[epinephrine]].<ref name="pmid17720019">{{cite journal |author=Annane D, Vignon P, Renault A, ''et al'' |title=Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial |journal=Lancet |volume=370 |issue=9588 |pages=676-84 |year=2007 |pmid=17720019 |doi=10.1016/S0140-6736(07)61344-0}}</ref> Similarly, another [[randomized controlled trial]] found no difference between [[vasopressin]] and [[norepinephrine]].<ref>Russell, J. A., Walley, K. R., Singer, J., Gordon, A. C., Hebert, P. C., Cooper, D. J., et al. (2008). [http://content.nejm.org/cgi/content/short/358/9/877 Vasopressin versus norepinephrine infusion in patients with septic shock], N Engl J Med, 358(9), 877-887. {{doi|10.1056/NEJMoa067373}}</ref>. | Among the choices for pressors for treating [[septic shock]], a [[randomized controlled trial]] concluded that there was no difference between the biogenic [[amine]]s [[norepinephrine]] (plus [[dobutamine]] as needed for [[cardiac output]]) versus [[epinephrine]].<ref name="pmid17720019">{{cite journal |author=Annane D, Vignon P, Renault A, ''et al'' |title=Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial |journal=Lancet |volume=370 |issue=9588 |pages=676-84 |year=2007 |pmid=17720019 |doi=10.1016/S0140-6736(07)61344-0}}</ref> Similarly, another [[randomized controlled trial]] found no difference between [[vasopressin]] and [[norepinephrine]].<ref>Russell, J. A., Walley, K. R., Singer, J., Gordon, A. C., Hebert, P. C., Cooper, D. J., et al. (2008). [http://content.nejm.org/cgi/content/short/358/9/877 Vasopressin versus norepinephrine infusion in patients with septic shock], N Engl J Med, 358(9), 877-887. {{doi|10.1056/NEJMoa067373}}</ref>. | ||
===Cardiogenic | ===Cardiogenic shock=== | ||
Among the choices for pressors | Among the choices for pressors for treating [[cardiogenic shock]], [[norepinephrine]] may be better than [[dopamine]] in reducing mortality. <ref>NEJM 2010 [http://content.nejm.org/cgi/content/full/362/9/779 Comparison of Dopamine and Norepinephrine in the Treatment of Shock]</ref> | ||
===Hypovolemic shock=== | |||
Among the choices for pressors for treating [[hypovolemic shock]], [[norepinephrine]] and [[dopamine]] are similar in reducing mortality.<ref>NEJM 2010 [http://content.nejm.org/cgi/content/full/362/9/779 Comparison of Dopamine and Norepinephrine in the Treatment of Shock]</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 08:50, 4 March 2010
In medicine and pharmacology, vasoconstrictor agents or vasopressor agents are "drugs used to cause constriction of the blood vessels."[1]
Examples of sympathomimetic vasoconstrictor agents include:
- Epinephrine [r]: A hormone (adrenalin) adrenergic systems-stimulator used in asthma and cardiac failure. [e]
- Norepinephrine [r]: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [e]
Examples of peptide hormone vasoconstrictor agents include:
- Vasopressin [r]: A hormone also called (arginine vasopressin, (AVP); formerly known as antidiuretic hormone, ADH), produced in the hypothalamus secreted from the posterior pituitary that causes kidneys to concentrate urine to conserve water, also causes vasoconstriction. [e]
Uses
Septic shock
Among the choices for pressors for treating septic shock, a randomized controlled trial concluded that there was no difference between the biogenic amines norepinephrine (plus dobutamine as needed for cardiac output) versus epinephrine.[2] Similarly, another randomized controlled trial found no difference between vasopressin and norepinephrine.[3].
Cardiogenic shock
Among the choices for pressors for treating cardiogenic shock, norepinephrine may be better than dopamine in reducing mortality. [4]
Hypovolemic shock
Among the choices for pressors for treating hypovolemic shock, norepinephrine and dopamine are similar in reducing mortality.[5]
References
- ↑ Anonymous (2024), Vasoconstrictor agent (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Annane D, Vignon P, Renault A, et al (2007). "Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: a randomised trial". Lancet 370 (9588): 676-84. DOI:10.1016/S0140-6736(07)61344-0. PMID 17720019. Research Blogging.
- ↑ Russell, J. A., Walley, K. R., Singer, J., Gordon, A. C., Hebert, P. C., Cooper, D. J., et al. (2008). Vasopressin versus norepinephrine infusion in patients with septic shock, N Engl J Med, 358(9), 877-887. DOI:10.1056/NEJMoa067373
- ↑ NEJM 2010 Comparison of Dopamine and Norepinephrine in the Treatment of Shock
- ↑ NEJM 2010 Comparison of Dopamine and Norepinephrine in the Treatment of Shock