Circulating shock ,whatever may be the cause produces hypo perfusion of tissues leading to organ
dysfunction and multi organ failure .It is usually associated with hypotension and increased lactate
levels and increased or decreased mixed venous saturation (SVo2) .Management includes , increase
in the blood volume and to maintain adequate cardiac of output (Co) and tissue perfusion .This
requires administration of vasoactive drugs .An attempt was made to describe the various vasoactive
drugs both inotropes and vasopressors, their mechanism of action, pharmacological effects and the
various side effects both immediate and late. Their usage in specific conditions like acute myocordial
infarction ; septic shock and post cardiac surgery state was discussed in detail .The choice of single
drug or a combination in these states is suggested based on the recommendations .It is imperative
that these drugs should be started early and requires judicious combination and dosage and should
not be continued for prolonged time. If they are required in chronic heart failure ,switching over to
oral drugs ,and using non pharmacological support with IABP, ventricular assist devices and finally
cardiac transplantation has to be considered.
Key words: Circulatory Shock, Vasoactive Drugs, Intotropes, Cardiac Stimulants
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