Dopamine (Intropin) Cardiac Arrhythmias

Question 1

Classification:

Answer 1

• Adrenergic agonist
• Inotropic
• Vasopressor

Question 2

Action:

Answer 2

• Stimulates alpha and beta adrenergic receptors
• At moderate doses (2 to 10 mcg/kg/min), dopamine stimulates beta1 receptors, resulting in inotropy and increased cardiac output while maintaining dopaminergic-induced vasodilatory effects
• At high doses (Greater than 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 w/ cardiogenic shock and septic shock
• Hypotension after ROSC following cardiac arrest
• Symptomatic bradycardia unresponsive to atropine

Question 4

Adverse Effects:

Answer 4

• Tachycardia
• Arrhythmias
• Skin and soft tissue necrosis
• Severe HTN from excessive vasoconstriction
• Angina
• Dyspnea
• Headache
• Nausea/vomiting

Question 5

Contraindications:

Answer 5

• Pheochromocytoma
• VF, VT, other ventricular arrhythmias
• Known sensitivity (Including sulfites)
• Correct any hypovolemia w/ 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 infusion by 5-10 mcg/kg/min to desired effect
• Cardiac dose is usually 5 to 10 mcg/kg/min
• Vasopressor dose is usually 10-20 mcg/kg/min

Question 7

Dosage (Pediatric)

Answer 7

• Same as adult dosing

Question 8

Special Considerations:

Answer 8

• Half life of 2 mins