Intropin

 

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.

 

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