Dopamine

General

• Type: Vasopressors
• Dosage Forms: IV
• Common Trade Names: Intropin

Indications

• Hypotension caused by:
  • Septic shock
  • Bradycardia
  • MI
  • Trauma/spinal shock
  • Heart failure

Adult Dosing

• Shock (adjunct):
  • 1-50 mcg/kg/min IV
    • Max 20-50 mcg/kg/min
    • Increase 1-4 mcg/kg/min q10-30 min, titrate to effect
• Refractory Heart Failure:
  • 1-3 mcg/kg/min IV
• Bradycardia (in patients unresponsive to atropine):
  • 2-10 mcg/kg/min IV
• Post-resuscitation stabilization:
  • 5-10 mcg/kg/min IV

Pediatric Dosing

• Shock (adjunct):
  • 5-10 mcg/kg/min IV (max dose of 20 mcg/kg/min)
    • Increase 1-4 mcg/kg/min q10-30 min, titrate to effect
• Post-resuscitation stabilization:
  • 2-20 mcg/kg/min IV/IO

Special Populations

• Pregnancy Rating: Class C
• Lactation: Use caution (limited data)
• Renal Dosing
  • Adult: no adjustment
  • Pediatric: no adjustment
• Hepatic Dosing
  • Adult: N/A
  • Pediatric: N/A

Contraindications

• Allergy to class/drug
• Tachyarrhythmias
• Pheochromocytoma

Adverse Reactions

Serious

• Anaphylaxis
• Hypotension
• Ventricular arrhythmias
• Bronchospasm
• Atrial fibrillation
• Extravasation necrosis
• Gangrene

Common

• Tachycardia
• Headache
• Nausea/vomiting
• Anxiety
• Hypertension
• Angina
• Palpitations
• Dyspnea
• Azotemia

Pharmacology

• Half-life:
  • 2 minutes
• Metabolism:
  • Renal, Hepatic, Plasma
• Excretion:
  • Urine as metabolites
• Mechanism of Action:

Primary Receptor

• Low dose: DA, β₁
• High dose: DA, α₁ >> β₁

Relative Effects

• Low dose: Natriuresis, ↑↑HR, ↑↑SV
• High dose: ↑SVR and ↑SV

See Also

• Vasopressors
• Dobutamine
• Cardiogenic shock
• Shock