Which medication is a vasopressor used to increase mean arterial pressure in shock?

Which medication is a vasopressor used to increase mean arterial pressure in shock?

• A. Norepinephrine (Levophed)
• B. Epinephrine
• C. Dopamine
• D. Nitroglycerin

Answer: (A)

In shock, increasing mean arterial pressure helps preserve organ perfusion, and a vasopressor used for this purpose acts mainly by constricting blood vessels. Norepinephrine (Levophed) is best because it strongly stimulates alpha-1 receptors, causing vasoconstriction that raises systemic vascular resistance and thus MAP. It also provides some beta-1 activity, which can support cardiac output without excessive heart rate increases. This combination effectively raises arterial pressure to meet the goal (often MAP ≥65 mmHg) while avoiding the higher tachycardia and arrhythmia risk seen with some other agents. Epinephrine also raises MAP but tends to cause more tachycardia and oxygen demand; dopamine has more variable, dose-dependent effects and more side effects; nitroglycerin dilates vessels and would lower MAP, not raise it. Use norepinephrine with careful titration and monitor for extravasation and ischemic complications.

In shock, increasing mean arterial pressure helps preserve organ perfusion, and a vasopressor used for this purpose acts mainly by constricting blood vessels. Norepinephrine (Levophed) is best because it strongly stimulates alpha-1 receptors, causing vasoconstriction that raises systemic vascular resistance and thus MAP. It also provides some beta-1 activity, which can support cardiac output without excessive heart rate increases. This combination effectively raises arterial pressure to meet the goal (often MAP ≥65 mmHg) while avoiding the higher tachycardia and arrhythmia risk seen with some other agents. Epinephrine also raises MAP but tends to cause more tachycardia and oxygen demand; dopamine has more variable, dose-dependent effects and more side effects; nitroglycerin dilates vessels and would lower MAP, not raise it. Use norepinephrine with careful titration and monitor for extravasation and ischemic complications.