Group 4 - Dopamine

Question 1

Dopamine

Drug Class?

Answer 1

Dopamine Drug Class:

• Sympathomimetic

Question 2

Dopamine

Mechanism of Action?

Answer 2

Dopamine Mechanism of Action:

• 1 - 2 mcg/kg/min: Cerebral, renal, and mesenteric vasodilation.
• 2 - 10 mcg/kg/min: ß₁ stimulation is primary effect (increased cardiac output).
• 10 - 20 mcg/kg/min: α stimulation is primary effect (renal, mesenteric, and peripheral arterial and venous vasoconstriction (increased SVR), increased pulmonary vascular resistance, and increased preload.
• >20 mcg/kg/min: Hemodynamic effects similar to norephinephrine; may increase HR and O₂ demand to undesirable limits.

Question 3

Dopamine

Indications?

Answer 3

Dopamine Indications:

• Symptomatic bradycardia
• Non-hypovolemic hypotension/shock (cardiogenic or septic shock AFTER fluid administration; assess breath sounds first)

Question 4

Dopamine

Contraindications?

Answer 4

Dopamine Contraindications:

• Hypovolemic shock
• Pheochromocytoma
• MAO inhibitors

Question 5

Dopamine

Adverse Reactions?

Answer 5

Dopamine Adverse Reactions:

• CV: cardiac arrhythmias, hypertension, hypotension at low doses
• GI: nausea and vomiting
• GU: renal shutdown at higher doses
• Other: extravasation may cause tissue necrosis

Question 6

Dopamine

Adult Dose?

Answer 6

Dopamine Adult Dose:

• Preparation: (If premixed not carried) Add 400 mg to 250 ml NS or D₅W = 1600 mcg/ml
• Bradycardia: Start at 5 mcg/kg/min IV infusion
• Shock: Cardiogenic or septic (non-hypovolemic)
• BP <70 systolic: Start at 5 mcg/kg/min IV infusion
• BP >70 systolic: Start at 2.5 mcg/kg/min IV infusion

Question 7

Dopamine

Pediatric Dose?

Answer 7

Dopamine Pediatric Dose:

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

Question 8

Dopamine

Onset of Action?

Answer 8

Dopamine Onset of Action:

• Almost immediate

Question 9

Dopamine

Peak Effects?

Answer 9

Dopamine Peak Effects:

• 5 - 10 minutes

Question 10

Dopamine

Duration of Action?

Answer 10

Dopamine Duration of Action:

• Effects cease almost immediately when infusion is shut off

Question 11

Dopamine

AZ Drug Box Minimum Supply?

Answer 11

Dopamine

AZ Drug Box Minimum Supply:

• 400 mg

Question 12

Dopamine

Special Notes?

Answer 12

Dopamine Special Notes:

• Always monitor drip rate, never run “wide open”
• An infusion pump is required for interfacility transports