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dopamine

C01CA04

Forms & Strengths

Injection concentrate: 40 mg/mL, 80 mg/mL, 160 mg/mL
Premixed infusion: 0.8 mg/mL, 1.6 mg/mL, 3.2 mg/mL in D5W

Adult Dosing

Renal/mesenteric vasodilation: 1 to 3 mcg/kg/min IV infusion
Inotropic effect: 3 to 10 mcg/kg/min IV infusion
Vasopressor effect: Greater than 10 mcg/kg/min IV infusion (up to 50 mcg/kg/min)

Pediatric Dosing

Continuous IV infusion: 1 to 20 mcg/kg/min titrated to desired hemodynamic response
Neonates: Initial infusion 1 to 5 mcg/kg/min, titrated up to 20 mcg/kg/min

Indications

Hemodynamic support in shock states (cardiogenic, septic, or hypovolemic after fluid resuscitation)
Correction of hemodynamic imbalance in myocardial infarction, trauma, endotoxic septicemia, and congestive heart failure

Mechanism of Action

Dopaminergic agonist at low doses, stimulating renal and mesenteric blood vessels
Direct beta-1 adrenergic agonist at moderate doses, increasing myocardial contractility and stroke volume
Alpha-1 adrenergic agonist at high doses, causing peripheral vasoconstriction and increased systemic vascular resistance

Contraindications

Pheochromocytoma
Uncorrected tachyarrhythmias or ventricular fibrillation
Known hypersensitivity to dopamine or sulfites (some formulations)

Adverse Reactions

Tachycardia, ectopic beats, palpitations, hypotension, vasoconstriction
Angina, dyspnea
Nausea, vomiting
Headache, anxiety
Gangrene of extremities with prolonged high-dose infusion or extravasation

Drug Interactions

Monoamine oxidase inhibitors (MAOIs): Potentiates pressor response, risk of severe hypertensive crisis
Beta-blockers: Antagonizes cardiac inotropic and chronotropic effects of dopamine
General anesthetics (halogenated hydrocarbons): Increased risk of ventricular arrhythmias
Phenytoin: IV administration with dopamine may cause severe hypotension and bradycardia

Curated Content: Needs Vetting Before Put to Clinical Use