Dopamine (Intropin)

Question 1

Class

Answer 1

Adrenergic agonist, inotropic, vasopressor

Question 2

Action

Answer 2

Stimulates alpha and beta adrenergic receptors. At moderate doses (2-10 mcg/kg/min), dopamine stimulates beta1 receptors, resulting in inotropy and increased cardiac output while maintaining dopaminergic-induced vasodilatory effects.

At high does (>10 mcg/kg/min), alpha adrenergic agonism predominates, and increased peripheral vascular resistance and vasoconstriction result

Question 3

Indications

Answer 3

Hypotension and decreased cardiac output associated with cardiogenic shock and septic shock, hypotension after return of spontaneous circulation following cardiac arrest, symptomatic bradycardia unresponsive to atropine

Question 4

Adverse Effects

Answer 4

Tachycardia, arrhythmias, skin and soft tissue necrosis, severe hypertensions from excessive vasoconstriction, agina, dyspnea, headache, nausea/vomiting

Question 5

Contraindications

Answer 5

Preochromoctyoma, VF, VT, or other ventricular arrhythmias known, known sensitiviy (including sulfites). Correct any hypovolemia with volume fluid replacement before administering dopamine

Question 6

Dosage (Adult)

Answer 6

2 to 20 mcg/kg/min IV, IO infusion. Starting dose 5 mcg/kg/min; may gradually increase the infusion by 5 to 10 mcg/kg/min; vasopressor dose is usually 10 to 20 mcg/kg/min.

Little benefit is gained beyond 20 mcg/kg/min

Question 7

Dosage (Pediatric)

Answer 7

Same as adult dosing

Question 8

Special Considerations

Answer 8

Half-life 2 mins; Pregnancy class C