Dopamine

Question 1

Dopamine Generic Name

Answer 1

Dopamine

Question 2

Dopamine Class

Answer 2

Sympathomimetic

Question 3

Dopamine MOA

Answer 3

Immediate metabolic precursor to norepinephrine

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

2-10 mcg/kg/min ß1 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 (SVR)
10-20 mcg/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 increased preload
>20 mcg/kg/min Produces hemodynamic effects similar to norepinephrine; may increase HR and O2 demand to undesirable limits

Question 4

Dopamine Indications and Field Use

Answer 4

Symptomatic bradycardia, hemodynamically significant hypotension in the absence of hypovolemia (cardiogenic or septic shock only after fluid administration; assess breath sounds first)

Question 5

Dopamine Contraindications

Answer 5

Hypovolemic shock (relative)
Pheochromocytoma
MAO inhibitors, such as Marplan, Nardil, or Parnate

Question 6

Dopamine Adverse Reactions

Answer 6

CV: Cardiac arrhythmias may occur due to increased myocardial oxygen demand (usually tachydysrhythmias), hypertension, hypotension at low doses.
GI: Nausea and vomiting
GU: Renal shutdown (at higher doses)
Other: Extravasation may cause tissue necrosis

Question 7

Dopamine Incompatibilities/Drug Interactions

Answer 7

Incompatible in any alkaline solution.

Onboard MAO inhibitors (older antidepressants) will cause hypertensive crisis.

Question 8

Dopamine Adult Dose

Answer 8

2-20 mcg/kg/min

Bradycardia: start at 5 mcg/kg/min
Shock (cardiogenic or septic):
Systolic BP < 70: start drip at 5 mcg/kg/min
Systolic BP > 70: start drip at 2.5 mcg/kg/min

Question 9

Dopamine Pediatric Dosage

Answer 9

2-20 mcg/kg/min for circulatory shock or shock unresponsive to fluid administration.

To prepare infusion for small children: 6 x body wt. in kg = mg added to NS to make 100 ml. With this mixture 1 ml/hr delivers 1 mc/kg/min; titrate to effect

Question 10

Dopamine Route

Answer 10

IV infusion

Question 11

Dopamine Onset

Answer 11

Almost immediate

Question 12

Dopamine Peak Effects

Answer 12

5-10 minutes

Question 13

Dopamine Duration of Action

Answer 13

Effects cease almost immediately when infusion is shut off

Question 14

Dopamine AZ Drug Box Minimum

Answer 14

400 mg