Editing Shock (circulatory) (section)

===Medications===
[[File:Epipen.jpg|thumb|Old version of the Epinephrine auto-injector]]
[[Vasopressors]] may be used if blood pressure does not improve with fluids. Common vasopressors used in shock include: [[Norepinephrine (medication)|norepinephrine]], [[phenylephrine]], [[dopamine]], and [[dobutamine]].{{cn|date=February 2025}}

There is no evidence of substantial benefit of one vasopressor over another;<ref>{{Cite journal |last1=Gamper |first1=Gunnar |last2=Havel |first2=Christof |last3=Arrich |first3=Jasmin |last4=Losert |first4=Heidrun |last5=Pace |first5=Nathan Leon |last6=Müllner |first6=Marcus |last7=Herkner |first7=Harald |date=2016-02-15 |title=Vasopressors for hypotensive shock |journal=The Cochrane Database of Systematic Reviews |volume=2 |issue=2 |pages=CD003709 |doi=10.1002/14651858.CD003709.pub4 |issn=1469-493X |pmc=6516856 |pmid=26878401}}</ref> however, using dopamine leads to an increased risk of arrhythmia when compared with norepinephrine.<ref>{{Cite journal |vauthors=Gamper G, Havel C, Arrich J, Losert H, Pace NL, Müllner M, Herkner H |date=February 2016 |title=Vasopressors for hypotensive shock |journal=The Cochrane Database of Systematic Reviews |volume=2 |issue=2 |pages=CD003709 |doi=10.1002/14651858.CD003709.pub4 |pmc=6516856 |pmid=26878401}}</ref> Vasopressors have not been found to improve outcomes when used for [[hemorrhagic shock]] from [[Trauma (medical)|trauma]]<ref>{{Cite journal |vauthors=Diez C, Varon AJ |date=December 2009 |title=Airway management and initial resuscitation of the trauma patient |journal=Current Opinion in Critical Care |volume=15 |issue=6 |pages=542–47 |doi=10.1097/MCC.0b013e328331a8a7 |pmid=19713836 |s2cid=19918811}}</ref> but may be of use in [[neurogenic shock]].<ref name="Trauma07">{{Cite journal |vauthors=Cocchi MN, Kimlin E, Walsh M, Donnino MW |date=August 2007 |title=Identification and resuscitation of the trauma patient in shock |journal=Emergency Medicine Clinics of North America |volume=25 |issue=3 |pages=623–42, vii |citeseerx=10.1.1.688.9838 |doi=10.1016/j.emc.2007.06.001 |pmid=17826209}}</ref> [[Activated protein C]] (Xigris), while once aggressively promoted for the management of [[septic shock]], has been found not to improve survival and is associated with a number of complications.<ref name=":marti-carvajal">{{Cite journal |vauthors=Martí-Carvajal AJ, Solà I, Gluud C, Lathyris D, Cardona AF |date=December 2012 |title=Human recombinant protein C for severe sepsis and septic shock in adult and paediatric patients |journal=The Cochrane Database of Systematic Reviews |volume=2018 |issue=12 |pages=CD004388 |doi=10.1002/14651858.CD004388.pub6 |pmc=6464614 |pmid=23235609}}</ref> Activated protein C was withdrawn from the market in 2011, and clinical trials were discontinued.<ref name=":marti-carvajal" /> The use of [[sodium bicarbonate]] is controversial as it has not been shown to improve outcomes.<ref name="bicarb08">{{Cite journal |vauthors=Boyd JH, Walley KR |date=August 2008 |title=Is there a role for sodium bicarbonate in treating lactic acidosis from shock? |journal=Current Opinion in Critical Care |volume=14 |issue=4 |pages=379–83 |doi=10.1097/MCC.0b013e3283069d5c |pmid=18614899 |s2cid=22613993}}</ref> If used at all it should only be considered if the blood pH is less than 7.0.<ref name="bicarb08" />

People with anaphylactic shock are commonly treated with [[Epinephrine autoinjector|epinephrine]]. [[Antihistamine]]s, such as [[Benadryl]] ([[diphenhydramine]]) or [[ranitidine]] are also commonly administered. [[Albuterol]], normal saline, and steroids are also commonly given.{{cn|date=February 2025}}