Dopamine

Question 1

Class / Action

Answer 1

Alpha/Beta Adrenergic Stimulator. Sympathomimetic. Dopaminergic.

1. Increases BP
2. At low dose of 1-5mcg/kg/min, Dopaminergic effects occur resulting in vasodilation of renal, mesenteric, and cerebral arteries increasing renal blood flow and urine output, but may not increase pulse or BP
3. At dose of 2-20mcg/kg/min, beta adrenergic effects (increased contractibility and chronotropic effect) occur resulting in increased cardiac output with minimal changes in systemic vascular resistance or preload
4. At does of 10-20mcg/kg/min, alpha-adrenergic effects occur resulting in vasoconstriction in the renal, mesenteric and peripheral arteries and veins.

Question 2

Onset / Duration of Action

Answer 2

Onset in 5min / Duration of 10min after infusion ends

Question 3

Indications

Answer 3

1. Symptomatic hypotension s/t non-hypovolemic states
2. Low cardiac output states such as cardiogenic, anaphylaxis, septic or neurogenic shock
3. Symptomatic bradycardia after atropine/pacing

Question 4

Contraindications

Answer 4

1. Uncorrected tachyarrhythmia d/t hypovolemia
2. V-Fib
3. Hypovolemic Shock

Question 5

Precautions

Answer 5

1. Avoid extravasation of dopamine into surrounding tissue. If IV infusion infiltrates, it Must be Immediately Removed. Notify the physician.
2. Do Not Mix with Sodium Bicarbonate or Similar Alkaline Solutions, because inactivation of Dopamine Will Result

Question 6

Dosages / Administration

Answer 6

1. Dopamine Must be Diluted Prior to Administration; mix 400mg in 250mL NS with a micro-drip (1600mcg/mL)
   a. Usual Infusion rate ranges from 2-20mcg/kg/min, titrations to individual patient response
2. May Use: DUGGAN FORMULA
   a. Estimate Pt’s weight in pounds
   b. Cross off the 3rd digit of the weight in pounds to get gets/min, (e.g. 183lbs = 18gtts/min)
   c. At 18gtts/min, you would be administering 5-6mcg/kg/min
3. May Use: Patient Weight in kg
   a. See Chart in Protocol Book

Question 7

Adverse Reactions

Answer 7

Hypersensitivity, SVT, Ventricular Arrhythmias (PVCs, V-Tach, V-Fib)