Dopamine Flashcards
Dopamine indication
Cardiogenic shock (pulmonary edema with NON-HYPOVOLEMIC hypotension)
Anaphylaxis refractory to epinephrine and fluid boluses
Bradycardia refractory to atropine and pacing
Shock states with Hemodynamically significant hypotension in the ABSENCE of
Hypovolemia (sepsis, neurogenic shock).
Crush injury
Dopamine side effect
Tachycardia, ectopic beats, nausea, vomiting, angina, palpitations, headache and dyspnea
High doses can cause hypertension requiring reduction in infusion rate.
Dopamine action
Precursor to norepinephrine an endogenous catecholamine. Stimulates alpha, beta and dopaminergic receptors in a dose –dependent fashion
2 – 5 mcg/kg/min Dilates renal, mesenteric and cerebral arteries by dopaminergic receptor stimulation (has minimal effect on blood pressure and heart rate).
5 – 10mcg/kg/min Predominately beta and alpha-adrenergic receptor stimulating actions increasing cardiac output (inotropic) with minor increase in systemic vascular resistance and preload
10 – 20mcg/kg/min Increasingly alpha adrenergic receptor stimulating actions resulting in increased peripheral, renal and mesenteric arterial and venous vasoconstriction which thereby increases systemic vascular resistance and preload.
Doses higher than 20mcg/kg/min produce pure alpha receptor effects mimicking norepinephrine effects. For this reason if hypotension is refractory to dopamine either
epinephrine infusions or Dobutamine infusions are added.
Onset of action: 1 – 2 minutes
Half life: 2 minutes
Dopamine class
Sympathomimetic
Dopamine contraindication
Hemodynamically significant hypotension secondary to
Hypovolemia from blood loss or dehydration
Hemodynamically significant hypotension secondary to
third spacing fluids prior to sufficient fluid replacement
Dopamine dose
Cardiogenic shock and bradycardia
5 – 10mcg/kg/min
Anaphylaxis
20mcg/kg/min
Crush syndrome
2mcg/kg/min
Pediatric dosing is the same as adult dosing
