Dopamine

PHARMACOLOGY & ACTIONS

• Endogenous catecholamine.

• Acts on both dopaminergic and adrenergic neurons.

• Dose dependent effects:

> 1─2 mcg/kg/min - dilates renal and mesenteric blood vessels, typically no effect on heart rate or blood pressure.

> 2─10 mcg/kg/min - beta effects on heart which increases cardiac output without greatly increasing heart rate or blood pressure.

> 10─20 mcg/kg/min - alpha peripheral effects causing peripheral vasoconstriction, which results in increase in systemic vascular resistance (SVR) and increased blood pressure.

> 20─40 mcg/kg/min - alpha effects reverse dilatation or renal and mesenteric vessels with resultant decreased flow. Increases heart rate and oxygen demand to undesirable limits.

INDICATIONS

• Treatment of refractory cardiogenic or distributive shock.

ABSOLUTE CONTRAINDICATIONS

• Hypovolemia.

• Dopamine allergy.

PRECAUTIONS & SIDE EFFECTS

• May induce tachyarrhythmias, in which case infusion should be decreased or stopped.

• High doses (10 mcg/kg) may cause peripheral vasoconstriction.

• Should not be added to sodium bicarbonate or other alkaline solutions since dopamine will be

inactivated in alkaline solutions.

• Consider hypovolemia and treat this with appropriate fluids before administration of dopamine.

• Dopamine is best administered by an infusion pump to accurately regulate rate. It may be hazardous when used in the field without an infusion pump. Monitor closely.

ADMINISTRATION

IV

Onset:

immediate

Peak Effect:

5─10 minutes

Duration:

effects during infusion

PROTOCOLS CONTAINING DOPAMINE

• Shock: Adult & Pediatric

• Bites and Envenomations: Adult & Pediatric