Dopamine

Question 1

Dopamine Classification

Answer 1

ALPHA/BETA ADRENERGIC STIMULATOR, SYMPATHOMIMETIC, DOPAMINERGIC

Question 2

Dopamine Action

Answer 2

1. Increase BP
2. Low dose = 1-2 mcg/kg/min, dopaminergic effects occur to vasodilation of renal mesenteric and cerebral arteries increasing renal blood flow and urine output, but may not increase BP or pulse
3. Med. dose = 2-10 mcg/kg/min, beta-adrenergic effects (increased contractibility & chronotropic effect) increase CO with minimal changes in systemic vascular resistance or preload
4. Large dose = 10-20 mcg/kg/min, alpha-adrenergic effects result in vasoconstriction in renal, mesenteric and peripheral arteries and veins.

Question 3

Dopamine Onset and Duration

Answer 3

1. 5 min

2. 10 min after infusion ends

Question 4

Dopamine Indication

Answer 4

1. HYPOTENSION 2ND TO NO-HYPOVOLEMIC STATES
2. LOW CO SUCH AS CARDIOGENIC, ANAPHYLACTIC, SEPTIC OR NEUROGENIC SHOCK
3. SYMPTOMATIC BRADYCARDIA AFTER ATROPINE/PACING

Question 5

Dopamine contraindication

Answer 5

1. Uncorrected tachyarrhythmia due to hypovolemia
2. V-fib
3. Hypovolemic shock

Question 6

Dopamine dosage and administration

Answer 6

1. Mix 400 mg in 250 mL NS with a mini drip (1600mcg/ml)
   a. Begin at 2.5-5mcg/kg/min up to 20mcg/kg/min, titrate to maintain BP>90/S
   b. Usual infusion rate ranges from two to 20 µg/kg/min. Titrate to individual patient response.
2. May use Duggan formula
   a. Estimate patient’s weight in pounds
   b. Cross off third digit of the weight in pounds to get gtts/min
   c. Base gtts/min off of chart
3. May use pt. weight in kg

Question 7

Dopamine adverse reaction

Answer 7

HTN, SVT, Ventricular arrhythmias

Question 8

Dopamine referencing protocol

Answer 8

Shock (hypotension in absence of trauma, anaphylactic shock, vasogenic/neurogenic shock)
Respiratory (difficulty breathing)
Cardiac