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Dopamine

DOPAMINE
(Intropin)

CLASS

Sympathomimetic, Inotrop, Vasopressor

DOSAGE
Initially 5 ug/kg/min; titrate to systolic blood pressure > 90mmHg.

ROUTE OF ADMINISTRATION
IV Drip (piggyback)

400mg in 500 cc 0.9% NS yields a concentration of 800 ug/ml; 400 mg in 250 cc, 800 mg in 500 cc, and 1600 mg in 1000 cc all yield a concentration of 1600 ug/cc.

Note that "street rules" for calculation of dopamine dose in drops per minute (weight in pounds, drop last digit, then subtract 1) are applicable only with concentrations of 1600 mg/ml.

ACTION

Chemical precursor of norepinephrine that stimulates dopaminergic, beta-2-adrenergic, and alpha-adrenergic receptors.

Dosage-related;
- 1-2ug/kg/min produces vasodilation of renal, mesenteric, and cerebral arteries.

- 2-10ug/kg/min stimulates both beta-1- and alpha-adrenergic receptors, resulting in increased cardiac output.

- > 10ug/kg/min stimulates alpha-adrenergic receptors, resulting in renal, mesenteric, and peripheral arterial and venous vasoconstriction.

NOTE: Administration of dopamine should be titrated to the desired hemodynamic effect (usually low normal blood pressure).

INDICATIONS

Indicated in cardiogenic shock and hemodynamically significant hypotension.

CONTRAINDICATIONS

Dopamine is contraindicated in patients with pheochromocytoma (causes serious acute hypertension).
Hypovolemia as related to extreme trauma.

WARNINGS

Patients receiving monoamine oxidase inhibitors should receive no more than one-tenth of the normal dosage of dopamine. Dopamine should not be discontinued abruptly but should be tapered gradually.

SIDE EFFECTS

Tachydysrhythmias may result from dopamine; ectopic beats, nausea and vomiting are more frequent adverse effects; may produce tissue necrosis and sloughing.

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