Dopamine

Question 1

Class

Answer 1

Sympathomimetic

Question 2

Indication

Answer 2

Sympathomimetic bradycardia

Hemodynamically sufficient hypotension in the absence of hypovolemia

Question 3

Contraindications

Answer 3

Hypovolemic shock

MAO Inhibitors

Pheochromocytoma

Question 4

Adult dose

Answer 4

Prep: add 400/250 ml NS or dextrose

Shock: Cardiogenic or septic
BP<70 systolic start 5 mcg
BP>70 systolic start 2.5 mcg

Peds
2-20 mcg/kg/min
6xbodywt

Question 5

Mech of action

Answer 5

Immediate metabolic precursor to Norepinephrine
Effects are dose dependent:
1-2mcg/kg/min. Acts on dopaminergic receptors to stimulate cerebral, renal and mesenteric vasculature dilate; HR AND B/P are usually unchanged;may increase urine output

2-10 mcg/kg/min. B1 stimulant action is primary effect(increases cardiac output and partially antagonizes the a-adrenergic mediated vasoconstriction. Overall effect is increased cardiac output and only modest increase in systemic vascular resistance

10-20mcg/kg/min a-adrenergic effects predominate resulting in Renal, mesenteric and peripheral arterial and venous vasoconstriction with marked increase in SVR, pulmonary vascular resistance and further increase preload

> 20 mcg/kg/min produces hemodynamic effects similar to nor epinephrine; may increase heart rate and O2 demand to undesirable limits