Dopamine: Difference between revisions

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==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Class C
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Class C
*Lactation:
*Lactation: Use caution (limited data)
*Renal Dosing
*Renal Dosing
**Adult: no adjustment
**Adult: no adjustment
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*Allergy to class/drug
*Allergy to class/drug
*Tachyarrhythmias
*Tachyarrhythmias
*Pheochromocytoma


==Adverse Reactions==
==Adverse Reactions==
*Low doses:
**Hypotension
*High doses:
**Hypertension, ectopic beats
*Tissue necrosis (if extravasates)
**If occurs use phentolamine 5-10mg in affected area
===Serious===
===Serious===
*[[Anaphylaxis]]
*[[Hypotension]]
*Ventricular arrhythmias
*Bronchospasm
*[[Atrial fibrillation]]
*Extravasation necrosis
*Gangrene


===Common===
===Common===
*[[Tachycardia]]
*[[Headache]]
*Nausea/vomiting
*Anxiety
*[[Hypertension]]
*[[Angina]]
*[[Palpitations]]
*[[Dyspnea]]
*Azotemia


==Pharmacology<ref>Dopamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. </ref>==
==Pharmacology<ref>Dopamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. </ref>==
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==See Also==
==See Also==
 
*[[Vasopressors]]
*[[Dobutamine]]
*[[Cardiogenic shock]]
*[[Shock]]


==References==
==References==

Revision as of 18:57, 16 March 2020

General

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

Adult Dosing

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):
    • 5-20 mcg/kg/min IV
      • 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

Common

Pharmacology[1]

  • 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

Notes

Indications

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

See Also

References

  1. Dopamine: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.