Dopamine
Dopamine (Inotropin)
Class:
Sympathomimetic, inotropic agent.
Sympathomimetic, inotropic agent.
Mechanism of Action:
Immediate metabolic precursor to Norepinephrine. Increases systemic vascular resistance (alpha 1 effects), dilate renal and splanchnic vasculature at low doses. Increases myocardial contractility and stroke volume (+ inotropy). Increases heart rate (+ chonotropy).
Immediate metabolic precursor to Norepinephrine. Increases systemic vascular resistance (alpha 1 effects), dilate renal and splanchnic vasculature at low doses. Increases myocardial contractility and stroke volume (+ inotropy). Increases heart rate (+ chonotropy).
Indications:
Cardiogenic, septic or spinal shock, hypotension with low cardiac output states. Distributive shock.
Cardiogenic, septic or spinal shock, hypotension with low cardiac output states. Distributive shock.
Contraindications:
Hypovolemic shock, pheochromocytoma, tachydysrhythmias, VF.
Hypovolemic shock, pheochromocytoma, tachydysrhythmias, VF.
Adverse reactions:
Cardiac dysrhythmias, hypertension, increased myocardial oxygen demand, extravagation may cause tissue necrosis.
Cardiac dysrhythmias, hypertension, increased myocardial oxygen demand, extravagation may cause tissue necrosis.
Drug Interactions:
- Incompatible with alkaline solutions.
- Beta blockers may antagonize effects of dopamine.
Adult Dosage and Administration
2 - 20 mcg / kg / min. (Rate determined by physician).
2 - 20 mcg / kg / min. (Rate determined by physician).
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Pediatric Dosage and Administration:2 - 20 mcg / kg / min. (Rate determined by physician).
Special Considerations:
- Pregnancy safety not established.
- Effects are dose-dependent.
- Dopaminergic response: 2-5 mcg / kg / min.: dilates vessels in kidneys; inc. urine output.
- Beta-adrenergic response: 4-10 mcg / kg / min.: Increased chronotropy and inotropy.
- Adrenergic response: 10-20 mcg / kg / min.: Primarily alpha stimulant / vasoconstriction.
- Greater than 20 mcg / kg / min.: reversal of renal effects override alpha effects.
- Always monitor drip rate.
- Avoid extravagation injury.