Drugs interact wit various tissues through receptors. The interaction of a drug and a receptor are a complex relationship like a lock and key. A lock and key have a complex three dimension structure, and if the structure of either the lock or key change, then they are not capable of interacting.
When a person is in shock they have may have a low blood pH or acidosis. Acidosis causes the structure of the receptors to change shape. When the shape of a lock changes, then a key will not work. This is the problem often with acidosis. When a person has a low plasma pH, some drugs will not be able to bind with receptors and produce the desired physiological response. This is a problem, because if you administer an adrenergic drug like norepinephrine (Levophed) to an acidotic patient you will not see the desired response of an increase in blood pressure.
Norepinephrine (Levophed) is an adreneric agent used to increase blood pressure. It binds with adrenergic receptors.
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