Which hormone is most helpful in maintaining blood pressure in a patient who has hypovolemic shock?

• A. Progesterone
• B. Epinephrine
• C. Glucocorticoids
• D. Norepinephrine

Answer: (D)

In hypovolemic shock, the goal is to restore intravascular volume and then support blood pressure if fluids alone don’t bring it up. Norepinephrine is most helpful because it strongly constricts blood vessels through alpha-adrenergic effects, raising systemic vascular resistance and arterial pressure. It also has some beta-1 activity that can support cardiac output, but its primary role is elevating blood pressure with fewer tachycardia risks than other vasopressors. Progesterone is not involved in acute BP support. Glucocorticoids may help if there’s adrenal insufficiency or in certain septic shock scenarios, but they’re not the first choice for maintaining BP in pure hypovolemic shock. Epinephrine can raise BP as well but tends to cause more tachycardia and higher myocardial demand, making norepinephrine the better, more controlled option for stabilizing pressure.