Dopamine Hydrochloride (Inotropin®)

Question 1

Dopamine - Class

Answer 1

• Sympathomimetic (naturally occurring catecholamine)

* Vasopressor with dopaminergic as well as alpha & beta adrenergic properties

Question 2

Dopamine - Actions

Answer 2

• Acts on alpha & beta adrenergic receptors as well as dopamine receptors
• At dosages from 1 - 10 mcg/kg/min - acts primarily on beta receptors causing a positive inotropic effect on the heart (also dilates blood vessels supplying brain, kidneys, heart, & GI tract)
• At dosages exceeding 10 mcg/kg/min - begins to stimulate alpha receptors, resulting in peripheral vasoconstriction
• Will increase systolic BP and pulse pressure

Question 3

Dopamine - Indications

Answer 3

• Shock/HoTN (non-traumatic)
• HoTN associated with CP (suspected cardiogenic shock)
• Anaphylaxis in extremis (severe HoTN, severe respiratory distress) - if pt still has HoTN after epi and fluids
• Respiratory distress of suspected cardiac etiology (CHF) if BP < 90 systolic
• Pulseless electrical activity (PEA)
• Symptomatic bradycardia with a pulse (CP, SOB, decreased LOC, BP < 90 systolic, pulmonary congestion) - after Atropine

Question 4

Dopamine - Dosage/Route

Answer 4

• 400 mg/250 ml NS - infused at 5 - 20 mcg/kg/min, titrate to systolic BP & cardiac rate/rhythm response

Question 5

Dopamine - Side Effects

Answer 5

• Ventricular irritability

* HTN & extreme vasoconstriction can occur with high infusion rates

Question 6

Dopamine - Contraindications

Answer 6

• Should not be the sole agent used in management of hypovolemia
• Should not be administered in presence of tachycardias or v-fib

Question 7

Dopamine - Special Information

Answer 7

• Tissue necrosis may occur with infiltration - D/C & circle area of infiltration & inform hospital
• Effects can cease approx 10 min after drip is stopped
• Assess effectiveness of admin by reassessing the BP & cardiac rhythm
• Will be deactivated if used with sodium bicarbonate

Question 8

Dopamine - Pediatric Note

Answer 8

• Refer to Pediatric Drug Guide
• 200 mg/250 ml NS - infused at 5 - 20 mcg/kg/min for:
  
  • Anaphylaxis
  • Shock/HoTN (non-traumatic)
  • Symptomatic bradycardia with pulse
  • PEA