Dopamine
Class
Sympathomimetic, Inotrop
Description
Dopamine is chemically related to epinephrine and norepinephrine. It acts
primarily on alpha-1 and beta-1 adrenergic receptors, increasing systemic
vascular resistance and exerting a positive inotropic effect on the heart. In
addition, the actions of this drug on dopaminergic receptors dilate renal and
splanchnic vasculature, maintaining blood flow. Dopamine is commonly used to
treat hypotension associated with cardiogenic shock.
Onset & Duration
Onset: 2-4 min.
Duration: 10-15 min.
Indications
1. Hypotension without hypovolemia
2. Shock without hypovolemia
3. Low cardiac output states
Contraindications
Patients with pheochromocytoma
Adverse Reactions
1. Dose-related tachydysrhythmias, ventricular fibrillation, ventricular
tachycardia
2. Hypertension
3. Increased myocardial oxygen demand
4. Nausea, vomiting
5. Headache
6. Ischemia
Drug Interactions
1. May be deactivated by alkaline solutions (sodium bicarbonate and furosemide)
2. MAO inhibitors and bretylium may potentiate the effect of dopamine.
3. Sympathomimetics and phosphodiesterase inhibitors exacerbate dysrhythmia
response.
4. Beta-adrenergic antagonists may blunt inotropic response.
5. When administered with phenytoin, hypotension, bradycardia, and seizures may
develop.
Special Considerations
1. Pregnancy safety: Category C
2. Infuse through a large, stable vein to avoid the possibility of extravasation
injury
3. Monitor patient for signs of compromised circulation.
Note: Feel free to discuss this medication and your experiences in administering it in an emergency or hospital based setting on our message board
