OCEMS DOPAMINE

OCEMT Paramedic Pharmacology: Dopamine

MEDICATION

• Name: Dopamine HCl (Intropin)

CLASSIFICATION

• Type: Sympathomimetic

EFFECTS/CHARACTERISTICS

• Receptor Stimulation:

  • Stimulates alpha, beta, and dopaminergic receptors.

• Lower Doses (2-10 mcg/kg/min):

  • Beta Adrenergic Effects:

    • Increased heart rate (chronotropy)

    • Increased force of contraction (inotropy)

    • Increased cardiac output

  • Dopaminergic Effects (Dominant effect in lower doses):

    • Dilation of renal and mesenteric blood vessels.

• Higher Doses (>10 mcg/kg/min):

  • Alpha Adrenergic Effects(dominant effect in higher doses):

    • Peripheral vasoconstriction

    • Increased heart rate.

PHARMACOKINETICS

• Onset: < 5 minutes

• Peak: Depends on dose.

• Duration: 10 minutes

DOSAGE FORM

• Available Forms:

  • 400 mg/10 ml Vial

  • 400 mg/10 ml Pre Filled Syringe

  • 400 mg/250 ml D5W prefilled IV bag

PREHOSPITAL ROUTES OF ADMINISTRATION

• Route: IV Piggy Back

• Dosage:

  • 2-10 mcg/kg/min intravenous (Max 20 mcg/kg/min until desired perfusion reached).

  • Same dosage recommended for Adults and Pediatrics.

SIDE EFFECTS

• Adverse Effects:

  • Dysrhythmias

  • Hypertension

PRECAUTIONS

• General Warning:

  • Recently replaced by push-dose Epi locally; however, remains part of NREMT curriculum.

  • Use cautiously in patients with tachydysrhythmia.

  • Ventricular dysrhythmias may occur requiring a reduction in infusion rate.

  • Higher dosages (>10 mcg/kg/min) may lead to excessive vasoconstriction.

• Compatibility:

  • Alkaline solutions inactivate dopamine; do not infuse simultaneously with Sodium Bicarbonate (NaHCO3) as it will precipitate in the IV tubing.

• Delivery:

  • Administer with approved rate flow regulator when available.

  • At doses exceeding 10 mcg/kg/min, excessive peripheral vasoconstriction may occur.

  • At doses exceeding 20 mcg/kg/min, renal and mesenteric vessel constriction may occur.