- Cardiogenic shock
- Septic or neurogenic shock when unresponsive to other measures
- Uncorrected tachyarrhythmias
- Hypovolemic shock
- Mix: 400 mg in 250 ml of NS or 800 mg in 500 ml NS to produce a concentration of 1600 mcg/ml.
INTRAVENOUS DRIP RATES FOR DOPAMINE
Concentration: 1600 mcg/kg/ml | All doses in mgtts/min
|Weight (kg)||5 (mcg/kg/min)||10 (mcg/kg/min)||15 (mcg/kg/min)||20 (mcg/kg/min)|
- Pressor agents worsen tissue hypoxia in the presence of hypovolemia from diuretics and poor intake; careful differentiation is necessary.
- Dopamine is best administered by an infusion pump to accurately regulate rate.
- Dopamine may induce tachy-dysrhythmias. If the heart rate exceeds 140, the infusion should be stopped.
- At low doses, decreased blood pressure may occur due to peripheral vasodilation. Increasing infusion rate will correct this.
- Should not be added to sodium bicarbonate or other alkaline solutions, since dopamine will be inactivated at higher pH.
- Tissue extravasion at the IV site can cause skin sloughing due to vasoconstriction. Be sure to make Emergency Department aware if there has been any extravasation of dopamine-containing solutions, so that proper treatment can be instituted.
- Can cause hypertensive crisis in susceptible individuals.
- Certain antidepressants potentiate the effect of this drug. Check for medications and if other medications are being used.
- Pharmacology and Actions
- Dopamine is a chemical precursor of epinephrine. It occurs naturally in humans
- Dopamine has the following dose related effects.
- 1-2 mcg/kg/min: dilates renal and mesenteric blood vessels (no effect on heart rate or blood pressure).
- 2-10 mcg/kg/min: beta effects on heart usually increase cardiac output without increasing heart rate.
- 10-20 mcg/kg/min: alpha peripheral effects cause peripheral vasoconstriction and increased blood pressure.
- 20-40 mcg/kg/min: alpha effects reverse dilatation of renal and mesenteric vessels with resultant decreased flow.
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