Kenneth L. Smith, Mercer University College of Pharmacy
Vasodilatory shock is a medical emergency where the organs and tissues undergo a decrease in perfusion which can lead to organ failure and death if not treated immediately. In this syndrome, a drop in blood pressure can occur despite preserved cardiac output.  When intravenous fluid resuscitation fails to restore blood pressure, few choices are available other than vasopressors such as catecholamines (or other sympathomimetics) in addition to vasopressin. However, these can be toxic at highdoses, and when these options fail, prognosis is considered poor. Angiotensin II is a component of the renin-angiotensin –aldosterone-system (RAAS) which causes the release of anti-diuretic hormone (ADH), also known as vasopressin, from the posterior pituitary. This leads to vaso-constrictive effects that can increase blood pressure. Consequently, use of angiotensin II for vasodilatory shock has been considered to provide a more natural physiological response to treat this serious condition.