What type of medication is first-line therapy for treating septic shock?

Norepinephrine is considered the first-line therapy for treating septic shock due to its effectiveness in increasing blood pressure and improving perfusion in critically ill patients. Septic shock is characterized by severe systemic infections leading to hypotension and inadequate tissue perfusion.

Norepinephrine primarily acts as a potent vasopressor, stimulating alpha-adrenergic receptors, which leads to vasoconstriction and an increase in systemic vascular resistance, thus elevating blood pressure. Additionally, norepinephrine has some beta-1 adrenergic activity, which can contribute to mild increases in cardiac output without significantly increasing heart rate or oxygen demand.

The clinical guidelines, such as those from the Surviving Sepsis Campaign, strongly recommend norepinephrine as the initial agent of choice for adult patients with septic shock. This recommendation stems from its established efficacy and safety profile in managing this critical condition.

In contrast, while epinephrine, dopamine, and phenylephrine can be used in certain situations, they are not preferred as first-line therapy due to various reasons such as adverse effects, cost-benefit profiles, or limited evidence supporting their use in septic shock management. For instance, while epinephrine may be effective in some cases, it can cause excessive increases