Dopamine

(Intropine)

Classification:

Sympathomimetic agent (catecholamine)

Increases blood pressure, cardiac output and improves blood flow to the kidneys.The therapeutic action depends on the receptors that are stimulated.

Low dose (1-2 mcg/kg/minute)

Dilates renal and mesenteric arteries(dopamine) Decreases blood pressure due to vasodilation (beta2) 

Moderate dose (5-10 mcg/kg/minute)

Increases inotropy without increasing chronotropy (beta1)

Increases blood pressure due to increased cardiac           output (beta1)

High dose (over 10 mcg/kg/minute)

Constricts blood vessels (alpha)

Increases inotropy and chronotropy (beta1)

Increases blood pressure due to vasoconstriction

and increase cardiac output (alpha and beta1)

Indications:            

Cardiogenic shock 

Distributive shock 

Symptomatic bradycardia

Contraindications:

Hypovolemia

Tachydysrhythmias

Adverse Effects:      

Cardiovascular

tachycardia                           

hypertension                                             

ventricular irritability                     

hypotension                                                                      chest pain                                        

vasoconstriction

Neurological          

headache

Respiratory

dyspnea         

Gastrointestinal

nausea/vomit

Administration:      

IV/IO drip

Low Dose                   1-2mcg/kg/min

Moderate Dose        5-10mcg/kg/min

High dose                  10-20mcg/kg/min

Concentration equal to 400mg/500ml NS IVPB.

Infuse via microdrip at 5-10 mcg/kg/min. 

200 mcg/min.= 15gtts/min.

400 mcg/min.= 30gtts/min.

600 mcg/min.= 45gtts/min.

800 mcg/min.= 60gtts/min.

Titrate to B/P of 90-100 systolic and signs of adequate perfusion or a maximum of 120 gtts/minute.

Pediatrics:    

Same as adult dose.

Onset:          

Duration:       

Onset:             1-2 minutes

Duration:       5-10 minutes

Precautions:           

Use large vein and verify IV patency prior to administration. Causes tissue necrosis if infused into interstitial space.

The infusion of dopamine should not be interrupted.  To ensure a consistent therapeutic blood level, establish an additional venous access site for the administration of fluids or additional medications.

Do not administer dopamine in the same IV line as sodium bicarbonate.

Dopamine is inactivated by sodium bicarbonate.