Dopamine

Question 1

Dopamine Hydrochloride (Intropin)

CLASS:

Answer 1

Vasopressor: Sympathomimetic ( Both alpha and beta properties)

Question 2

Dopamine Hydrochloride (Intropin)

ACTION:

Answer 2

• At low and medium doses, selectively dilates blood vessels supplying the brain, kidneys, heart and gastrointestinal tract.
• At medium to high doses, increases cardiac output by improving contractility and stroke volume, thereby increasing blood pressure.
• At high doses, causes vasoconstriction and increased heart rate.
• ONSET = < 5 Minutes
• DURATION = approximately 10 min after drip is stopped.

Question 3

Dopamine Hydrochloride (Intropin)

INDICATIONS:

Answer 3

Discomfort/Pain ? Cardiac origin (S-126)

-with associated shock if BP is refractory to second fluid bolus.

Shock ? Cardiac (S-138)

-if BP refractory to second fluid bolus

Shock ?Anaphylactic, Neurogenic (S-138)

-If BP refractory to fluid bolus

Sepsis (S-143)

-If BP refractory to fluid boluses

Anaphylaxis (S-122)

-If BP refractory to fluid bolus and epinephrine

Dysrhythmias (S-127)

-Bradycardia: after max atropine or initiation of TCP

Question 4

Dopamine Hydrochloride (Intropin)

DOSAGE/ROUTE:

Answer 4

ADULT ONLY 10-40 mcg/kg/min in 250ml NS or D5W IV/IO Drip:

Titrate to Maintain systolic BP ≥ 90 not to exceed 120 BHO

Question 5

Dopamine Hydrochloride (Intropin)

CONTRAINDICATIONS

Answer 5

None

Question 6

Dopamine Hydrochloride (Intropin)

SIDE EFFECTS:

Answer 6

• At high infusion rates, hypertension and extreme vasoconstriction may occur
• At low infusion rates, hypotension may occur
• Tachyarrhythmias, palpations
• Increased myocardial O2 Demand

Question 7

Dopamine Hydrochloride (Intropin)

CONCENTRATION:

Answer 7

400mg in 250ml NS = 1600mcg / 1ml

Question 8

Dopamine Hydrochloride (Intropin)

SPECIAL INFORMATION:

Answer 8

1. Approved optional premix solution of 400mg dopamine in 250ml D5W.
2. Tissue necrosis occurs with infiltration; if this occurs discontinue the IV circle the infiltrated area and inform receiving facility.
3. Titrate dosing to match systolic BP ≥ 90 not to exceed 120
4. Always run as a piggyback drip, never run as primary IV. Turn primary line off during dopamine infusion
5. To get quick estimate of dose (always confirm calculations and dose according to the dopamine drip chart):
   
   • to calculate 10mcg/kg/min drip rate: use patients weight in pounds, drop the last number and subtract 10% and then multiply X 2.

Question 9

Dopamine Hydrochloride (Intropin)

DOSAGE RANGE

Answer 9

LOW (dopaminergic)

2-5 mcg/kg/min

MEDIUM (beta range)

6-20 mcg/kg/min

HIGH (Alpha range)

> 20 mcg/kg/min