A 72-year-old female admitted for pneumonia develops septic shock. Despite adequate fluid resuscitation and broad-spectrum antibiotics, she remains hypotensive (MAP < 65 mmHg) requiring high-dose norepinephrine. Her blood glucose is 180 mg/dL. What is the next most appropriate pharmacological intervention?

The correct answer to the question "A 72-year-old female admitted for pneumonia develops septic shock. Despite adequate fluid resuscitation and broad-spectrum antibiotics, she remains hypotensive (MAP < 65 mmHg) requiring high-dose norepinephrine. Her blood glucose is 180 mg/dL. What is the next most appropriate pharmacological intervention?" is Option A: Administer vasopressin.

The other options — B) Initiate continuous insulin infusion, C) Start a phenylephrine infusion, D) Give an additional fluid bolus — are incorrect for this USMLE Exam Prep question. As explained above: If septic shock persists despite adequate fluid resuscitation and high-dose norepinephrine, vasopressin (a non-adrenergic vasopressor) is recommended as a second vasopressor agent. It acts via V1 rec…